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Complexity CPT codes for OT and PT - Therapy Playground

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CPT 97003 - will be replaced with the following evaluation codes as of 1/1/2017: OT Evaluation - Low Complexity - CPT 97165 OT Evaluation - Moderate Complexity - CPT 97166 OT Evaluation - High Complexity - CPT 97167

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PDF New Occupational Therapy Evaluation Coding Overview

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codes describe differences in complexity of evaluations, ranging from low (i.e., straightforward), to moderate (i.e., in- ... following introduction to the codes for Occupational Therapy Evaluation: Occupational therapy evaluations include an occupational profile, medical and therapy history, relevant assessments, and develop- ...

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Evaluation Codes for Occupational Therapy Billing

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Occupational therapy evaluation codes are divided into three tiers based on complexity: low, moderate, and high.

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PDF CPT Eval Codes for Occupational Therapy Cheat Sheet

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On January 1, 2017, the CPT codes for OT evaluations and re-evaluations (codes 97003 and 97004) will be replaced by a new, tiered set of codes. Use the following cheat sheet to familiarize yourself with the codes and to determine complexity levels based on a set of criteria.

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PT and OT Evaluation Code Decision Chart - CPT Complexity ...

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Take a peek at the PT and OT Decision Chart for CPT Evaluation Codes by Complexity. All PT and OT Codes on 1 document - Reference sheet; Use the information to help guide you in selecting the appropriate complexity based on requirements; The requirements for PT and OT are different. If you only need to have information for your specific ...

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Physical Therapy Codes | OT Evaluation Codes | ClinicSource

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Occupational therapists also must select from a new set of three tiered OT evaluation codes when billing for patient evaluations. And like the new PT codes, these codes are organized by complexity. The occupational therapy codes to be used with your occupational therapy software are: 97165

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PDF CMS Manual System

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complexity and the level of clinical decision-making - low, moderate and high complexity: for PT, codes 97161, 97162 and 97163; and for OT, codes 97165, 97166 and 97167. PT and OT re-evaluation codes. One new PT code, 97164, and one new OT code, 97168, were created to replace the existing codes - 97002 and 97004, respectively. The re ...

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New 2017 PT & OT Evaluation Codes including 97003 ...

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97161 - Physical therapy evaluation: low complexity 97162 - Physical therapy evaluation: moderate complexity 97163 - Physical therapy evaluation: high complexity. For occupational therapists, CPT code 97003 (Occupational therapy evaluation) is being deleted and replaced with three new CPT codes. The three new CPT codes are:

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A Complete Guide to Occupational Therapy Billing

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OT Evaluation CPT Codes. Occupational therapy evaluation codes are broken into three tiers based on the level of complexity. Each one has a corresponding CPT code. An occupational therapy reevaluation has a single CPT code. Below is a brief snapshot of what an evaluation at each level would typically involve. Low Complexity Evaluation (OT 97165)

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UPDATED: Occupational, Physical and Speech-Language ...

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UPDATED: Occupational, Physical and Speech-Language Therapy: Updated Codes, Classifications for Telehealth. Date: 04/23/21 Effective March 27, 2020, Superior HealthPlan implemented an expansion of Occupational, Physical and Speech-Language Therapy (OT, PT, ST) benefits through synchronous (video) telehealth service delivery for re-evaluation and treatment services.

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Occupational Therapy Procedure Codes - Wisconsin

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Occupational Therapy Procedure Codes. Covered OT services are identified by the allowable CPT and HCPCS procedures codes listed in the following table.. Note: Procedure codes for many OT services are defined as 15 minutes. One unit of these codes = 15 minutes. If less than 15 minutes is used, bill in decimals.

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PDF DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for ...

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codes are based on patient complexity and the level of clinical decision-making - low, moderate and high complexity: for PT, codes 97161, 97162 and 97163; and for OT, codes 97165, 97166 and 97167. Re-evaluation Codes. One new PT code, 97164, and one new OT code, 97168, were created to replace the existing codes - 97002 and 97004, respectively.

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Preparing for the New CPT Codes (with Complexity Criteria ...

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Correct Code: 97166 (Moderate-Complexity OT Evaluation) Because Jane has such an extensive history of physical, cognitive, and psychosocial challenges that impact her current functional abilities, the OT must conduct an intensive review of her records. Additionally, in the assessment, the OT finds seven performance-related deficits currently ...

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PDF Occupational therapy billing, coding and documentation ...

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occupational therapy assistant may contribute to the re-evaluation and progress summary; however, the final responsibility for the documentation, and the signature and credentials, must include that of the occupational therapist. • Every treatment summary and progress note in the patient medical record must contain

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Last Updated: May 28, 2022
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