• October 1, 2023
  • blog

Navigating the maze of medical codes can be a complex challenge for anyone in the healthcare industry, but for physical and occupational therapists, it’s a critical aspect of practice management. Understanding the appropriate Current Procedural Terminology (CPT) codes is crucial for accurate billing and ensuring the sustainability of your practice.

Whether you’re a seasoned therapist or new to the field, this guide aims to streamline your documentation process, allowing you to focus on what matters most—providing quality care to your patients.

Why Accurate Coding Matters in Physical Therapy and Occupational Therapy

Accurate coding is more than just a clerical task; it’s an integral component of effective therapy practice management.

Using the correct Current Procedural Terminology (CPT) codes ensures that you’re properly reimbursed for the services you provide, impacting the financial health of your practice.

It also plays a role in patient care, as accurate codes help convey the specific treatments administered, facilitating better communication among healthcare providers.

Additionally, precise coding is crucial for compliance with legal and insurance requirements, helping you avoid costly audits, fines, or even legal action. In short, getting your codes right is essential for sustainability, credibility, and optimal patient care.

What are the Three Most Common CPT Codes for Physical Therapy?

When it comes to physical therapy, there are three CPT codes that you’ll likely encounter frequently. These codes are fundamental for documenting common treatments and ensuring that you’re appropriately compensated for your services. Here’s a quick rundown:

  • 97110: Therapeutic Exercises – This code is used for specific exercises aimed at improving range of motion, strength, and endurance. These exercises can be passive, active-assisted, or active
  • 97112: Neuromuscular Reeducation – This covers treatments that aim to restore movement, balance, coordination, kinesthetic sense, and posture. Techniques might include proprioceptive neuromuscular facilitation (PNF), Feldenkrais, and Bobath
  • 97116: Gait Training – This is employed for walking and stair-climbing therapy, usually applied after surgery or injury that affects mobility

Understanding these common CPT codes can simplify your billing process and help you focus more on patient care, making them essential knowledge for any physical therapy professional.

What are the Three Most Common CPT Codes for Occupational Therapy

Occupational therapists frequently utilize a set of CPT codes that are pivotal for adequately documenting the treatments they administer. These codes not only help in ensuring proper billing but also in streamlining the practice’s operations. Here are the three most common CPT codes used in occupational therapy:

  • 97165: Occupational Therapy Evaluation – This code is used for initial evaluations that assess factors such as motor skills, sensory processing, and functional performance
  • 97535: Self-Care/Home Management Training – This code covers the training and education provided to patients for activities like meal preparation, basic hygiene, and managing finances
  • 97110: Therapeutic Exercise – Though also common in physical therapy, this code is widely used in occupational therapy for exercises intended to improve functions like strength, flexibility, and range of motion

Understanding and utilizing these key codes can help occupational therapists efficiently manage their billing and administrative tasks, allowing them to focus more on the primary goal—improving patients’ lives through targeted therapy.

3 Common Mistakes Made Using CPT Codes

When it comes to using CPT codes, even small errors can lead to big problems like delayed reimbursements, increased audit risks, and compromised patient care. Some common pitfalls to watch out for include:

  • Using Outdated Codes – CPT codes are updated annually, so using last year’s code could lead to claim denials
  • Code Mismatch – Ensure that the codes you’re using align with the documentation. Mismatched codes can trigger audits and fines
  • Overcoding or Undercoding – Using a code that represents a more complex procedure than performed can be considered fraudulent while undercoding can lead to reduced reimbursement

By being vigilant and avoiding these common mistakes, healthcare providers can enhance practice efficiency, improve billing accuracy, and ultimately provide better patient care.

How to Stay Updated on CPT Code Changes

Staying current with CPT code changes is crucial for the smooth operation of any healthcare practice. Given that these codes are updated annually and sometimes more frequently, healthcare providers need a strategy to keep up-to-date. Several effective methods include:

  • Subscribe to Industry Newsletters: Organizations like the American Medical Association (AMA) often send out updates on coding changes
  • Online Forums and Social Media: Professional groups on platforms like LinkedIn often share insights and updates on CPT code revisions
  • Continuing Education: Many educational courses, both online and in-person, offer training on CPT coding that includes the latest updates

By actively keeping abreast of code modifications, you can mitigate the risk of claim denials, avoid audits, and ensure consistent, quality care for your patients.

With HelloNote, we’ve got you covered. Our EMR system will keep CPT codes up-to-date and ensure you have access to all the codes you need to run your practice and give your patients all the care and attention they need.

Final Thoughts: Keeping Your CPT Codes Updated in Your EMR Software

In summary, staying current with CPT codes is essential for accurate billing, compliance, and ultimately, the success of your healthcare practice. An efficient way to manage this ever-changing landscape is through an intuitive EMR system that stays updated with the latest code revisions.

HelloNote is designed to make this aspect of your practice seamless and efficient. With features that include automatic updates and notifications for CPT code changes, HelloNote allows you to focus more on patient care and less on administrative hassles.

Ready to simplify your coding process and enhance your practice management? Click here to learn more about HelloNote and how it can transform your therapy practice.

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