97110 CPT Code: Know Your Codes
Basics of 97110 CPT Code
CPT code 97110 is a therapeutic procedure, on one or more areas, each lasting 15 minutes. Therapeutic exercises are performed in either an active, active-assisted or passive (e.g., treadmill, isokinetic exercise, lumbar stabilization, stretching, strengthening) approach. The exercises may be reasonable and medically necessary for a loss or restriction of joint motion, strength, functional capacity or mobility that has resulted from a specific disease or injury. Therapeutic exercise is considered medically necessary if at least one of the following conditions is present and documented:
- The patient has weakness, contracture, stiffness secondary to spasm, spasticity, decreased range of motion, gait problem, balance and/or coordination deficits, abnormal posture, muscle imbalance; or
- The patient needs to improve mobility, stretching, strengthening, coordination, control of extremities, dexterity, range of motion, or endurance as part of activities of daily living training, or re-education.
Documentation must show objective loss of joint motion, strength or mobility (e.g., degrees of motion, strength grades, levels of assistance). Therapeutic exercise includes activities related to strengthening, endurance training, range of motion, and flexibility. These activities can include use of free weights, exercise machines such as treadmills and range of motion exercises (passive and active). Therapeutic exercises describe services aimed at improving a parameter, such as strength, range of motion, etc.
Therapeutic Procedures Codes (97110-97546)
Therapeutic procedures codes (97110-97546) were added to CPT in 1995 to clarify the differences between Therapeutic Procedures, Modalities, and Tests and Measurements. A Therapeutic Procedure is defined as ‘a manner of effecting change through the application of clinical skills and/or services that attempt to improve function.’ These procedures require direct one-on-one patient contact by a physician or therapist. The descriptions for most of these codes reflect 15-minute intervals.
- Documentation must show objective loss of joint motion (degrees of motion), strength (strength grades), or mobility (levels of assistance)
- Documentation must show how these therapeutic exercises are helping the patient progress towards their stated, objective and measurable goals
- The exercise is reasonable and necessary if it is performed for the purpose of restoring functional strength, range of motion, endurance training, and flexibility
Checkpoints for 97110 CPT Code
- Does this exercise improve functional strength, range of motion, endurance and/or flexibility?
- Did I document an objective loss of joint motion (in degrees), strength (in a strength grade) or mobility (in a level of assistance)?
- Does my documentation have clear, objective goals that are measurable?
- Did I document how these exercises help reach those states objective goals?
CPT © Copyright 2021 American Medical Association
We hope that this article has provided basic guidelines about the 97110 CPT code. If you are looking for overall billing and coding services you can refer to E2E Medical Billing Services. Our accurate and affordable billing services will eliminate billing and coding errors and will increase your practice collection. To know more about our medical billing and coding services, call us at 888-552-1290 or write to us at info@e2eMedicalBilling.com