 |  |
Insurance Codes for OT with a Sensory-Based Approach1/24/2005 299.8 Pervasive Developmental Disorder/Asperger's Syndrome 314.0 Attention Deficit Disorder 314.01 Attention Deficit Disorder with Hyperactivity 315.4 Developmental Coordination Disorder 315.8 Delay in Development (specified) 315.9 Delay in Development (unspecified) 343.9 Cerebral Palsy 348.3 Encephalopathy 349.9 Unspecified Disorders of the Nervous System 382.9 Otitis Media 742.9 Unspecified Anomaly of the Brain, Spinal Cord and Nervous System 759.83 Fragile X Syndrome 781.3 Lack of Coordination 781.0 Tremors Nervous system 782.0 Disturbance of Skin Sensation 784.69 Motor Apraxia CPT Codes that can be used for Treatment 97110 Therapeutic Exercises (procedures) 97112 Neuromuscular Re-Education 97530 Therapeutic Exercises (activities) 97770 Self-Care/Home Management In a Private OT clinic recently surveyed, these are the evaluation and treatment codes most frequently used: Evaluation Codes 96110 OT Eval- developmental assessment interpretation, report 96111 OT Eval- extended standardized developmental instruments 96115 Neurobehavioral status exam with interpretation report 96117 Neuropsychological testing with interpretation report 97003 Medicaid/CMS Evaluation Treatment Codes: 97110 Therapeutic Procedure - develop strength/endurance. ROM/flex 97112 Neuro-muscular Re-Education - balance, coord.,proprio 97250 Myofascial Release/Mobilization - hand, wrist 97265 Joint Mobilization - hand wrist 97504 Orthotics Fitting - upper/lower extremity 97620 Prosthetic Training 97530 Therapeutic Activities - improve functional performance 97535 Self-Care/ADL Training 97537 Community Training 97532 Development of Cognitive Skills to Improve Attention Memory Each insurance company has their own particular guidelines, and restrictions. Be sure you know the preferences of the insurance company before you bill for your clients. Some OTs who do fee for service help their clients by calling the insurance companies for them, even though the insurance goes to the parent not the OT. Code: 97770 Sensory Integration/Cognitive Skills yielded a wide response in the SI (SIS) survey, from 0% to 100% with an average of 57% reimbursement. However in many states this is an absolute 'NO' as it always brings a response of 'not covered'. This is a recent response one OT got back from Blue Sheild/ Blue Cross: " The request for coverage for Occupational therapy is not approved. Sensory integration therapy is not covered as it is considered investigational by medical policy. Peer reviewed medical literature in support of this modality's efficacy and outcomes may be forwarded." Back to Library Mail this page to a friend | |
|
Follow Us:    |
  |
|
|
|
 |
|
|
