As occupational therapists, your focus should be on your clients, especially the little ones. You’ve got busy practice and people who rely on you, and your documentation has to be up-to-date and compliant, especially when CPT code changes happen. At HelloNote, we want you to be armed with the info you need to make the best EMR choices for your practice while staying compliant and up to date. Continue reading for an in-depth review of the frequency of CPT code changes for pediatric occupational therapeutic services. CPT codes are an essential part of your billing process, and when they change unexpectedly, they can hold up billing and put your compliance in jeopardy. There are ways you can stay proactive and on top of the changing CPT codes for your pediatric occupational therapy practice and ensure your billing, scheduling, and charting aren’t impacted by CPT code changes. 

Pediatric CPT Codes

CPT codes or “current procedural terminology codes” are the alphanumeric codes used by pediatric occupational therapists to identify and bill for services and keep your records up-to-date. CPT codes help create accurate patient/client charting and documentation and ensure occupational therapists are reimbursed by insurance and in good standing with their overseeing compliance office. CPT Codes correspond with the specific interventions and treatments you provide so other providers and healthcare insurers can understand the type of therapy provided, duration, and complexity of the services your client receives. CPT codes help make your charting fast, efficient, and universally accessible/understandable to your team and other providers. 

Do Pediatric CPT Codes Change Often?

CPT codes for pediatric occupational are updated yearly and it’s unlikely for occupational therapy codes to change mid-year. The yearly pediatric CPT code changes often reflect a shift in healthcare policies, updated clinical practices or diagnostics, or make room for advancements in medical technology and treatment types. 

Why Pediatric CPT Codes Change Yearly

  1. Feedback from occupational therapists and other healthcare professionals and organizations.
  2. Changes in diagnostic criteria for pediatric conditions that require occupational therapy may change over time. When this criteria is updated, it can change the impact of service types provided by occupational therapists and therefore require an update in Cpt codes.
  3. Streamlining procedures to simplify the coding process and increase clarity for the providers, insurance companies, and clients.
  4. As research and evidence-based practices change and lead to new treatment protocols, this can cause the need for changes to basic billing CPT treatment codes. This can also trigger a change in regulation and regulatory billing and coding requirements.
  5. New treatment techniques evolve and require new CPT codes.
  6. Technological changes that result in new assessments and therapies as well as software compatibility issues can require CPT codes to change. 

CPT code changes are overseen by the CPT Editorial panel. This panel executes changes in the CPT codes used by all medical professionals and comprises independent experts who volunteer their expertise and represent a wide breadth of healthcare professionals. They’re required to conduct evidence-based reviews of code changes and ensure new CPT codes adhere to specific treatment criteria. The panel meets three times a year to review changes to existing codes and consider new code types.

Stay Updated One Pediatric Occupational CPT Codes

Pediatric occupational therapy codes change yearly in January. Typically billing professionals and insurance companies should be prepared for new code rollouts, but it doesn’t hurt to be prepared. Your practice must stay updated on any changes to pediatric occupational therapy codes so you can appropriately bill insurance and keep your charting up to date. The best ways to stay on top of CPT changes and avoid billing issues are:

  1. Review contacts and payment agreements with your insurance companies to clarify any CPT code changes and how they might affect your reimbursement rates and insurance acceptances. 
  2. Get caught up on documentation at the end of the year so you’re not crossing your wires on what code should be used and when. Even if you saw a client on December 29th, and then again on January 2nd, their codes may be different for the same treatment they were receiving just days apart. 
  3. Stay in touch with billing professionals, insurance companies, and patients so your billing and reimbursement process isn’t impacted and doesn’t hold up a patient’s access to your services. 
  4. Educate your team and work with colleagues, practice supervisors, and your billing staff to make sure everyone understands the new CPT codes and their uses. 
  5. Make time for professional development to stay current on the latest developments and trends and evidenced-based best practices so you can adjust to the new pediatric occupational CPT codes when they come out.
  6. Make sure you regularly check for updates and revisions to CPT codes, as billing and insurance companies may roll out their changes earlier or later in the year and the two periods may not align. 

HelloNote’s Occupational Therapy EMR Software

HelloNote makes coding easy without breaking the bank. You’re vital to a pediatric patient’s rehabilitation, helping improve their independence, quality of life, and more. You shouldn’t have to fight with complicated charting systems that are expensive and have more bells and whistles than you need, or out-of-date software that crashes constantly and messes up your billing. With our comprehensive EMR software, we alleviate much of your documenting stress. We are the leading EMR provider for physical, occupational, and speech therapy practices. We lead the industry because we are therapists and we know how important it is to have the information you need at your fingertips. We understand your daily stressors and are dedicated to helping you decrease charting and administrative burdens, improving compliance, and increasing efficiency are the foundations of our success. HelloNote comprehensively combines billing, charting, and scheduling in one place so you’re focused on your clients, not a bunch of open tabs. Contact us to learn more about how HelloNote can help your occupational therapy practice. 

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