Wiki Cpt code 97001 and 97002 defination

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kumeena

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Good morning everyone

How often the Physical therapist can use 97002? Everytime PT used 9701X or 9711X can I use 97002?

What modifier I need when I use these codes?

Thank you
 
Do you have access to CPT Assistant? If so, check the December 2003 edition. It explains perfectly the correct use of these codes and provides clinical examples.
 
I am sorry . I do not have CPT assistant. Is there any other way I can get a copy or Free website link I can take a look?


Thank U
 
97002 is for a re-evalution of the plan of care, some carriers require one every 30 days. This visit should include a re-exam for the area of focus- shoulder, knee... it also should include if the patient is improving (ROM, pain etc) and is on target with the goals that have been set at the first evaluation. During the re-eval the PT will set the next session of planned goals.
Sometimes the plan may need to be adjusted if the patient should encounter another set back that would warrent the provider to adjust the treatment plan, this would need a documented description of the set back in order to charge for the re evaluation out of the normal time frame of 30 days.
 
Re evaluations

97002 is for a re-evalution of the plan of care, some carriers require one every 30 days. This visit should include a re-exam for the area of focus- shoulder, knee... it also should include if the patient is improving (ROM, pain etc) and is on target with the goals that have been set at the first evaluation. During the re-eval the PT will set the next session of planned goals.
Sometimes the plan may need to be adjusted if the patient should encounter another set back that would warrent the provider to adjust the treatment plan, this would need a documented description of the set back in order to charge for the re evaluation out of the normal time frame of 30 days.
 
I agree with Jeanut on the definition of the re-eval.

The correct modifier to use if you are billing treatment codes with a 97001 or 97002 is -59. For PT and Medicare patients, you would us GP. GO is for OT patients.
 
Evaluation/ Medicaid/ Mass Health or other Medicaid

I was wondering if anyone eles has had any experence when a payer will retract money due to the fact that an eval was billed with treatment codes on the same day?
 
My Ortho physician wants to bill 97001. In chart, it says, "continue therapy, discussed with patient and her nurse case manager."

Would the 97001 be correct? This is not a Medicare patient.

He's just started using this code, and I'm in the dark about it. I also do not have the CPT assistant, so I would love some helpful feedback on this.

Thanks!
 
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