Occupational Therapists (OT) Billing CPT Codes 

CPT or Current Procedural Terminology is a set of numeric or alphanumeric codes that are used by health practitioners to report medical procedures. CPT codes are also used when claiming insurance and collecting information for epidemiologic uses. CPT codes are composed of 5 characters and can be grouped into the following three categories. 

1. CPT Codes Category I

The majority of the CPD codes are included in category I. These codes comprise five digits and are used to report healthcare procedures that are authorized by the U.S. Food and Drug Administration (FDA). The main sections of the category I CPT codes are evaluation, management, anesthesia, surgery, radiology, pathology, and other medical procedures and services.    

2. CPT Codes Category II

CPT codes in this category are also comprised of five characters but include an alphabet ‘F’ at the end. These are supplemental tracking codes that report patients’ attributes and determine the quality of treatment to yield better results.  

3. CPT Codes Category III

CPT codes of category III are also composed of four numbers and an alphabet ‘T’. These alphanumerical codes are temporary and depict advancements in the field of healthcare – the emergence of technology and new procedures. The codes are added into the category I once approved and they are discarded if not used by the healthcare providers within a period of five years. 

CPT codes are commonly used by physicians, physical therapists, occupational therapists, and speech therapists. [1]

Occupational Therapists and CPT Codes

Occupational therapy is a subspecialty concerned with promoting social, physical, and mental health, well-being, and participation of individuals in a society. The occupational therapists ensure that the individuals are maintaining a healthy lifestyle which plays a significant role in the prevention and early detection of various health conditions. Occupational therapists work to decrease the risk of hospital visits and re-visits from injuries and debilitating health conditions. [2] Similar to practitioners in other fields of healthcare, occupational therapists also use CPT codes to report and bill their services. 

Occupational therapy evaluations comprise of the occupational status, medical history, assessment, analysis, interpretation, and treatment plan. Occupational therapy involves the coordination between the occupational therapist, patient, and the patient’s family to reach a common conclusion and devise a plan of action. Occupational therapy evaluation is important for evaluating the performance deficit in an individual. Performance deficits are referred to a lack of basic skills in an individual that eventually leads to failure to complete the assigned tasks. Performance deficits can be categorized into:

1. Physical skills

This refers to the physical impairment of the body and the inability to carry out normal body functions. Mobility, motor coordination, strength, and balance are a few physical skills that are compromised in individuals suffering from performance deficits. 

2. Cognitive Skills 

Cognitive skills refer to the inability of the brain to acquire knowledge, analyze information, and use the knowledge to solve problems. Problems with cognitive function precipitate when an individual is required to select the task and tools, perform the tasks and encounter a problem while performing that task.

3. Psychosocial skills

Psychosocial skills can be described as social behavior, habits, and the ability to adapt to the environment by making use of coping strategies. 

The CPT codes for occupational therapy evaluation are as follows. [3]

Occupational therapy is an important branch of medicine that helps an individual to gain independence in all aspects of his or her life. Occupational therapy emphasizes the cognitive, physical, emotional, psychological, and social well-being of an individual. Occupational therapists achieve this aim by conducting evaluation or re-evaluation assessments and then devising a plan of care for their patients. The services offered by an occupational therapist are encoded by the CPT codes. CPT codes are numeric/alphanumeric codes and are an integral part of healthcare. CPT codes are used for reporting the services offered by the occupation therapists and the procedures performed by them. In occupational therapy, CPT codes are determined by the duration, patient presentation, and evaluation tests performed by the therapist. 

Referencias 

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476805/ 
2. https://www.aota.org/-/media/Corporate/Files/Advocacy/Federal/coding/Descriptors-of-New-CPT-Occupational-Therapy-Evaluation-Codes.pdf