2017 New Physical Therapy Evaluation Codes – Final Rule
Oct14

2017 New Physical Therapy Evaluation Codes – Final Rule

Here comes 2017 and we have 3 New Physical Therapy Evaluation Codes. CMS has proposed a new physical therapy codes for 2017 as part of the Medicare Physician Fee Schedule (CMS-1654-P) proposed rule for 2017 . We have now the: 2017 New Physical Therapy Evaluation Codes Key Points: Each of these codes are not “time-based”; typical time is used as a guidance only Complexity (low-medium-high) Therapy Evaluation encounter MUST meet Medical Necessity and clearly documents FUNCTION Use these new therapy evaluation codes for Medicare and commercial payers; Workers’ Comp and MVA liability may still be using 97001/97002 CPT Code 97001 is DELETED and REPLACED by 3 new physical therapy evaluation Codes CPT Code 97002 is DELETED and REPLACED by one single re-evaluation code These New Physical Therapy Evaluation Codes has 4 Components of Complexity and Severity: Patient Medical and Functional HISTORY, which includes relevant comorbities and personal factors; Comorbities/pre existing conditions that affects function and ability to progress through a plan of care History of Functional limitation(s) and level; current functional level, abilities and limitations Identify and Document Personal Factors that may impact the plan of care for Physical Therapy treatment; eg. age, gender, social history, education background, lifestyle, coping styles, job/profession, present/past experience. Document the overall behavior patterns including experience with disability Existing personal factors that will not impact the plan of care should not be used when selecting the level of service Examination of body system(s) using standardized tests and measures; Body Structures: Anatomical or structural parts of the body, eg., the organs, limbs and their components, classified according to the body systems; Body Regions: Includes the Head, neck, back, lower extremities, upper extremities and trunk Body Systems: Musculoskeletal (range of motions, strength, weight/height, symmetry) Neuromuscular (coordinated physical/body movement which includes gait transfers, locomotion and transitions) and motor functions on control and learning Cardiovascular Pulmonary (RR, HR, BP and Edema) Integumentary (skin integrity, texture, presence of scar formation) Review of Systems should also include orientation of person, place and time; consciousness, the ability to express/show needs, anticipated emotional and or behahavioral responses Clinical Presentation of the patient Stable and uncomplicated, OR Evolving clinical presentation with changing clinical characteristics OR Evolving clinical presentation with unstable and unpredictable characteristics Clinical Decision Making (based including the utilization of standardized patient assessment tools and or using the Functional Outcome measurable assessment result The codes are based in large part on the amount of time and complexity involved in the evaluation. See below identifies the new physical therapy codes for 2017 and gives the long-form description of each code. 2017 New Physical Therapy Evaluation Codes  CPT Code 97161 Physical therapy evaluation: low complexity, requiring these components: A history...

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