Orthopedic Coding Alert

Question: Our physician is performing functional capacity evaluations (FCEs) in the office. Which code should I use to report this service?

Florida Subscriber

Answer: To bill FCEs, use 97750 (Physical performance test or measurement [e.g., musculoskeletal, functional capacity], with written report, each 15 minutes). Because this is a timed code, your orthopedist will have to document time to report this code correctly. You may be tempted to use the range-of-motion or manual muscle testing codes (95831-95852) for this procedure, but that wouldn't be correct. According to the February 2004 CPT Assistant, you would use 95831-95852 if the physician's only intent is to perform a complete range-of-motion or manual muscle testing (for example, to compare the right and left sides).

On the other hand, 97750 represents a more comprehensive service and includes performance testing, CPT Assistant says.