Eli's Rehab Report

Published on Sat Feb 05, 2005 PDF

Question: Would you tell me the procedure code for neuromuscular re-education?


Kentucky Subscriber

Answer: You should use CPT 97112 (Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities).

CPT defines this therapeutic procedure as a "manner of effecting change through the application of clinical skills and/or services that attempt to improve function."  
 
The physician or therapist must have one-on-one contact with the patient to bill for this procedure. These services may be provided "incident-to" a physician's services, in which case the physician would have to supervise the therapist directly in his office.

Many carriers have a policy that establishes standard treatment range for this service (e.g., Empire limits it up to 16 visits within a four- to six-week period), which uses stretching, strengthening and specialized biomechanical exercises to allow patients to find new ways to rest, hold, balance and move their bodies. And the Medicare carrier for Alabama states in the recently revised LCD for occupational therapy: "No greater than 1-2 services/units of this code are generally covered on each visit date. If this code is used in conjunction with CPT 97110 or CPT 97530 on any given visit date, only 1-2 service/units of CPT 97112 should be billed. Documentation must support the number of services/units for each visit date." Ask your payer for details.