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cpt coding for early intervention
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cpt coding for early intervention - December 29, 2003 11:06:00 AM
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judykid
Posts: 1
Joined: December 18, 2003
From: fghgfj
Status: offline
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Where can I get cpt codes for such things as: ther ex, ROM, positioning, developmental stimulation etc.? My county now requires that I put the ICD-9 code and the cpt codes on all progress notes. I am planning to get the ICD-9 from the doctor.
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Re: cpt coding for early intervention - December 31, 2003 5:08:00 AM
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gerry
Posts: 235
Joined: July 6, 1999
From: Montgomery, AL, USA
Status: offline
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CPT codes can be found many places. The AMA publishes CPT codes yearly. I use the source put out by Ingenix and the APTA titled "Coding and Payment Guide for the Physical Therapist". It contains lots of helpful info regarding documentation, etc.
You have to look through the CPT codes and find the ones that best describe what you are doing. There are no specific pediatric codes. I would suggest attending a good coding course. I have been to several, and would recommend the one the APTA sponsors.
gerry
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Re: cpt coding for early intervention - January 12, 2004 2:47:00 AM
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Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
Status: offline
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Here are a few codes to get you started:
97001: PT Evaluation (Untimed code)
97002: PT Re-evaluation (Untimed Code)
Early intervention PT's don't usually use passive codes such as hot packs, traction, etc. so we'll skip those.
97032: Attended e-stim (each 15 minutes) This code is used for tandem massage or motor point stimulation.
The following codes are timed by each 15 minutes, and the PT is required to have direct one-on-one patient contact
97110: Therapeutic procedure to one or more area (therex to develop strength, endurance, ROM and/or flexibility)
Indented codes under 97110 (e.g. specific kinds of therex --- some of which pay more under certain 3rd party pay sources, some less), include the following:
97112: Neuromuscular re-education of movement (balance, coordination, postural correction, proprioception, NDT)
97113: Aquatics
97116: Gait training
97124: Massage
The following are independent codes, not indented under 97110:
97140: Manual therapy including MFR, mobilization, manipulation, and manual traction (timed code)
97150: Group therapy (untimed)
97530: Therapeutic activities for functional performance(timed)
97532: Development of cognitive skills to improve attention, memboery, or problem solving (timed)
97533: SI techniques (timed)
97535: ADL training (timed)
97537: Community integration training (timed)
Be aware, however, that understanding CPT coding is just a fraction of what you need to know. For example:
1. You need to understand the 8 minute rule in some counties/states (e.g. only 8 minutes needs to be used in order to bill your first or last code, but all other codes in the session MUST be 15 minutes long) or a 15 minute rule in others (e.g. under NC medicaid, PT's MUST complete a full 15 minutes of any code used in order to bill without fraud).
2. You need to understand cross-walking. Under some 3rd party pay sources, some CPT codes are non-allowed for certain diagnosis (for example, some disallow payment for 97112 if NDT is conducted with a child with CP, but will pay for it under 97110), and others disallow payment for specific code interactions (e.g. 97110 and 97530 cannot be conducted on the same date of service under some plans).
I would suggest a comprehensive discussion with your supervisor regarding these issues, and/or a CE course on coding and billing. The questions you're asking are just the tip of the iceberg.
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Re: cpt coding for early intervention - December 31, 2003 5:08:00 AM
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gerry
Posts: 235
Joined: July 6, 1999
From: Montgomery, AL, USA
Status: offline
|
CPT codes can be found many places. The AMA publishes CPT codes yearly. I use the source put out by Ingenix and the APTA titled "Coding and Payment Guide for the Physical Therapist". It contains lots of helpful info regarding documentation, etc.
You have to look through the CPT codes and find the ones that best describe what you are doing. There are no specific pediatric codes. I would suggest attending a good coding course. I have been to several, and would recommend the one the APTA sponsors.
gerry
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Re: cpt coding for early intervention - January 12, 2004 2:47:00 AM
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Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
Status: offline
|
Here are a few codes to get you started:
97001: PT Evaluation (Untimed code)
97002: PT Re-evaluation (Untimed Code)
Early intervention PT's don't usually use passive codes such as hot packs, traction, etc. so we'll skip those.
97032: Attended e-stim (each 15 minutes) This code is used for tandem massage or motor point stimulation.
The following codes are timed by each 15 minutes, and the PT is required to have direct one-on-one patient contact
97110: Therapeutic procedure to one or more area (therex to develop strength, endurance, ROM and/or flexibility)
Indented codes under 97110 (e.g. specific kinds of therex --- some of which pay more under certain 3rd party pay sources, some less), include the following:
97112: Neuromuscular re-education of movement (balance, coordination, postural correction, proprioception, NDT)
97113: Aquatics
97116: Gait training
97124: Massage
The following are independent codes, not indented under 97110:
97140: Manual therapy including MFR, mobilization, manipulation, and manual traction (timed code)
97150: Group therapy (untimed)
97530: Therapeutic activities for functional performance(timed)
97532: Development of cognitive skills to improve attention, memboery, or problem solving (timed)
97533: SI techniques (timed)
97535: ADL training (timed)
97537: Community integration training (timed)
Be aware, however, that understanding CPT coding is just a fraction of what you need to know. For example:
1. You need to understand the 8 minute rule in some counties/states (e.g. only 8 minutes needs to be used in order to bill your first or last code, but all other codes in the session MUST be 15 minutes long) or a 15 minute rule in others (e.g. under NC medicaid, PT's MUST complete a full 15 minutes of any code used in order to bill without fraud).
2. You need to understand cross-walking. Under some 3rd party pay sources, some CPT codes are non-allowed for certain diagnosis (for example, some disallow payment for 97112 if NDT is conducted with a child with CP, but will pay for it under 97110), and others disallow payment for specific code interactions (e.g. 97110 and 97530 cannot be conducted on the same date of service under some plans).
I would suggest a comprehensive discussion with your supervisor regarding these issues, and/or a CE course on coding and billing. The questions you're asking are just the tip of the iceberg.
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