Neurology & Pain Management Coding Alert

  Question: A new provider recently joined our group practice and has begun to offer cognitive and sensory skills training for stroke victims and others. In the past, we reported such services using 97770, but I can no longer find 97770 in CPT. Any suggestions? Florida Subscriber Answer: CPT eliminated 97770 in 2001 and replaced it with two, more precise codes: 97532 (Development of cognitive skills to improve attention, memory, problem solving, [includes compensatory training], direct [one-on-one] patient contact by the provider, each 15 minutes) and 97533 (Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct [one-on-one] patient contact by the provider, each 15 minutes). Code 97532 describes therapy for adults with diagnoses of psychiatric disorders, brain injuries or cerebrovascular accidents. This type of cognitive-skills training allows individuals to live independently, return to work and function safely in their environment. Code 97533, in contrast, describes sensory integrative techniques that help patients respond to environmental demands. Although physicians most often apply this code when treating pediatric patients, it can also be used with adults with diagnoses such as autism (299.0x), developmental disorders, attention deficit disorders, cerebral palsy (343.0-343.9) and motor apraxia (784.69). Assigning diagnoses to accompany 97532/97533 can be difficult for a neurologist. Some insurance carriers assume that only a psychiatric professional may report any condition from the mental disorders (290-319) section of the ICD-9. Be sure to include all applicable diagnoses and contact your payer ahead of time for guidelines. - Clinical and coding expertise for You Be the Coder and Reader Questions provided by Neil Busis, MD, chief of the division of neurology and director of the neurodiagnostic laboratory at the University of Pittsburgh Medical Center at Shadyside, and clinical associate professor in the department of neurology, University of Pittsburgh School of Medicine; and Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS, director and senior instructor for CRN Institute, an online coding certification training center based in Absecon, N.J.