Applying a hot pack to warm up tissue before therapy, or an ice pack to reduce inflammation afterward, is standard practice. However, billing CPT 97010 to Medicare is a guaranteed $0 payment.
Medicare''s Bundling Rule
Medicare considers the application of hot or cold packs (97010) to be a "bundled" service. They believe the reimbursement for this modality is already built into the payments for the other primary therapy codes (like 97110 or 97140) billed that day.
Medicare will assign a Status Indicator of "B" (Bundled) to 97010, meaning you cannot bill the patient for it, and you will not get paid for it.
Commercial Payers
Unlike Medicare, some commercial payers (like certain BCBS or Worker's Comp plans) DO pay for 97010. Because of this, most EMRs are set up to automatically drop 97010 onto the claim for all patients, letting the payer sort it out.
NCCI Edits
Do NOT try to use Modifier 59 to unbundle 97010 for a Medicare patient. It is a permanent bundled status and will never be paid by Medicare, regardless of modifiers.