Wiki Pt 97002

Lennox, SD
Best answers
Wondering if anyone can give any insight on the use of the 97002. I recently had a physical therapist tell me that as a general rule work comp guidelines require a reevaluation every two weeks or 6th visit. He wanted to bill a 97002 even though he was discharging the patient from care which just doesn't seem right. If anyone has any information on these general work comp guidelines that would be very helpful.
Work comp payers can make any guidelines or requirements they want, as long as they fall within the state-specific laws as WC falls under the control of each individual state. I don't think it's necessarily a good idea to assume a reevaluation is necessary every 2 weeks; not only does it call into attention the medical necessity of it, it's also a gamble as to whether or not that's going to get paid.

"You can report 97002 if the therapy reevaluation is part of the plan of treatment with clinical rationale or a physician’s order supports it." If the patient is being discharged from care, why would any reevaluation need to be done? There's nothing left to review or change in the course of treatment as the course of treatment is over.