CPT^® 97161, Under Physical Therapy Evaluations

The Current Procedural Terminology (CPT^®) code 97161 as maintained by American Medical Association, is a medical procedural code under the range - Physical Therapy Evaluations.

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Summary

The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's current status is stable and uncomplicated; and assess one to two elements relating to body structure and function, and limitations, such as joint flexibility, muscle strength, gait, mobility, and neuromuscular function. She uses standardized tests and measures and employs clinical decision–making of low complexity, typically involving 20 minutes of face–to–face time with the patient or family or both.

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Physiotherapy initial evaluation billing guidelines - 97161

Hi, Greetings! Can anyone assist on the coding/billing guidelines regarding the allowed time limit to bill initial physiotherapy codes(97161-97163), its related to presenting condition/disease or any ... [ Read More ]

PT Eval 97161 denying per Molina

[QUOTE="MandyMW1, post: 501368, member: 678546"] Did you find a solution to this? We've been struggling to get Molina WA to pay eval codes as well. [/QUOTE] Hi Mandy, I was told by multiple reps that ... [ Read More ]

Physical Therapy Office Setting Billed Professionally

Good evening fellow coders! I recently accepted my first coding job in a physical therapy clinic. I am searching for some great resources on modifiers and how/when to use them appropriately with the p... [ Read More ]

PT Eval 97161 denying per Molina

Hey all, Molina continues to deny every physical therapy eval 97161 w/mod GP. The denials all state "Benefit is excluded from benefit plan". Molina is fairly new to us, so is there something that I ... [ Read More ]

IEHP Medi-Cal IE codes

Does anyone bill EIHP Medi-cal for physical therapy services? I am getting denials for the initial evaluation codes (97161-97163). Apparently, they use X codes. Greatly appreciate any input on this... [ Read More ]

95831- Manual Muscle Testing

Yes it has been deleted as of the 2020 CPT year. There are instructions: To report manual muscle testing, see Physical Medicine and Rehabilitation services [URL='https://www.supercoder.com/cpt-codes/... [ Read More ]

Physical therapy- new eval with a re-eval

Hello, I have come across a few office notes where our physical therapist is Re- evaluating the patient's initial problem while also doing a new eval on new problem that is NOT related to the initial... [ Read More ]

Closed finger joint capsulotomy

I code for hand surgeons and although they have never done this in the office, the 26520 code clearly states "physician removes or incises the joint capsule to release the contracture and restore func... [ Read More ]

99358

Thank you so much for the research. However it looks like that WC will pay for it. [COLOR="#0000FF"]Official Medical Fee Schedule – Physician/NonPhysician Services will be updated as of March 1, 2... [ Read More ]

BCBS paid 97161-25?

hey, i notice that the new girl in my office billed 97161-25 and BCBS MA paid for that. I was confused since 97161 wasn't E/M code, my evidence was weak and not strong enough to convince my boss that ... [ Read More ]

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