PT and OT Evaluation Coding Essentials

On January 1, 2017 new Common Procedural Codes Terminology or CPT codes were formerly introduced for physical and occupational therapy evaluations. CPT, authored by the American Medical Association, aims to provide uniform language for health care professionals to code medical services. The goal is to streamline reporting, and to increase efficacy. The decision to modify evaluation coding came about after careful deliberation with AOTA, APTA, the Centers for Medicare and Medicaid, other insurers and other key stakeholders. Why is this change a huge win for PT and OT professionals? It allows us to capture the complexities of the patients you work with every day in practice. Prior to 2017 all evaluations were coded the same, regardless of the time, effort, and critical thinking skills needed by the therapist to perform the service. Now that we have coding options, how do we know which evaluation code to choose? And why does it even matter? Data is being compiled and could result in increased reimbursement in the near future. Therefore, PTs and OTs are charged with the responsibility of using critical thinking to select a code that accurately reflects the complexity of the evaluation.

This course will discuss the dos and don’ts of complexity code selection and several reasons why it is important to choose correctly; including ethical and legal considerations. Several case examples will be provided to integrate theory into practice, as well as a Complexity Code Selection Guide. Return to the clinic ready to code confidently and accurately every time. 

To view accreditation information and access completion requirements to receive a certificate for completing this course, please click here.

The content of this Summit podcast is provided only for educational and training purposes for licensed physical therapists and occupational therapists. This content should not be used as medical advice to treat any medical condition in either yourself or others.