Eli's Rehab Report
Billing OT Evaluation With ADL Training
Question: If an occupational therapist (OT) instructs a patient in a home exercise program during an initial evaluation, can I bill CPT 97535 in addition to the initial OT evaluation code (97003)?
Illinois Subscriber
Answer: There isn't a bundling edit published by the Correct Coding Initiative (CCI) that prohibits billing these codes together, so you should bill the evaluation and activities of daily living (ADL) separately. Document all activities performed in conjunction with training the patient so the insurer doesn't question whether the training should have been part of the consultation. In addition, be sure to document that the therapist not an assistant performed the 97535 (self care/home management training [e.g., ADL and compensatory training, meal preparation, safety procedures, and instructions in use of adaptive equipment], direct one-on-one contact by provider, each 15 minutes).
Eli's Rehab Report
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