Eli's Rehab Report
Crutch Training Code Depends on Practitioner
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Question: When we teach a patient how to use crutches, should we report CPT 99211 or a more in-depth code? Sometimes this training takes 20 minutes or more. Answer: Depending on your carrier's guidelines, you should be able to report 97116 (Therapeutic procedure, one or more areas, each 15 minutes; gait training [includes stair climbing]) if the crutch training is part of the therapist's treatment plan (and the physician has approved it). -- You Be the Coder and Reader Questions were reviewed by Laureen Jandroep, OTR, CPC, CCS-P, CPC-H, CCS.
Montana Subscriber
Don't expect additional reimbursement, however. Most insurers pay about the same for 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician) as they pay for 97116.
Because your practitioner generally administers the crutch training for about 20 minutes and 97116 is billed in 15-minute increments, you can't report more than one unit of 97116. And, if your office's nurse performs the crutch training, you should not report 97116, because most state guidelines do not allow registered nurses to report the PM&R codes.
Eli's Rehab Report
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