CPT® 97755, Under Physical Medicine and Rehabilitation Tests and Measurements
The Current Procedural Terminology (CPT®) code 97755 as maintained by American Medical Association, is a medical procedural code under the range – Physical Medicine and Rehabilitation Tests and Measurements.
CPT code 97755, assistive technology assessment (e.g., to restore, compensate for an existing function or augment, optimize functional tasks and / or maximize environmental accessibility), direct one-on-one contact with written report, each 15 minutes, has been added to the following local coverage determinations (LCDs):
- (L34428) Outpatient Physical Therapy
- (L34427) Outpatient Occupational Therapy
- (L34560) Home Health-Occupational Therapy
- (L34564) Home Health-Physical Therapy
This is an assessment code, per each 15 minutes, and must be go together with by a written report explanation the nature and difficulty of the assistive technology needed by the patient. This can include: testing multiple components/systems to determine optimal interface between client and technology applications and determining the appropriateness of commercial (off the shelf) components/systems. If the service provided by a physical or occupational therapist is more clearly defined by another CPT code (for example, 97535 self-care/home management training), it should be used instead.
Use of CPT code 97755
It would be unfortunate to use the CPT code 97755 for services other than for those who have lost the use of their limbs and who can benefit from new technology developments. CPT 97755 should only be billed by occupational and physical therapists that have the additional knowledge and expertise of the assistive technology that is required for these individuals.
Coverage is specifically for assessment of mobility and seating systems that require high level adaptation, not for routine seating and mobility systems (e.g., manual/power wheelchair evaluations).
The patient’s voluntary motions (e.g., oral motor strength, head/neck range of motion and strength, ocular motor control, quality of voice output and client’s ability to use the accessibility components and systems) are identified and assessed. Multiple systems/components are tested to determine optimal interface between client and technology applications. Appropriateness of commercial (off-the-shelf) components/systems is determined. The need for modification of commercial components/systems is assessed. Custom components/systems are designed and tested as needed for the patient. Utilization of this service should be infrequent.
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