FWA Insights: Flagging potential physical therapy schemes

In physical medicine, there are occasions when using a general CPT code may be the only way to define treatment given. Unorthodox treatments are not unheard of, and although it’s rare, there are instances when the only code to use is a catchall code like CPT 97799. However, when vague codes are used repeatedly, this can be a red flag for fraud, waste, and abuse (FWA), with bad actors creating physical therapy treatments that aren’t treatments at all.