The new evaluation codes can be used in a number of ways.

As of January 1, 2017, all therapists must use a new set of codes to bill for therapy evaluations and re-evaluations.We are merely the messengers if we are being perfectly accurate.

You might think it’s hard to believe, but the evaluation and re-evaluation codes that have come to know and love are going away forever.There will be a brand new crop of evaluative codes that rehab therapists have never used before.This change applies to all entities covered by the Health Insurance Portability and Accountability Act, not just Medicare.

Are you worried?Don’t be.Everything you need to know about the new codes will be explained in this post.Is it sound good?Let’s start.

The evaluation code will not be the same for every patient.They will choose from a set of codes that are tiered according to complexity.The codes are listed.

When billing for patient evaluations, occupational therapists must use a new set of three tiered codes.The codes are organized by complexity.

The codes for OT re-evaluations are affected by this update.The re-evaluation codes are not tiered according to complexity.There are two replacement codes for 97002 and 97004.

The million-dollar question for any therapy professional affected by these coding updates is how to choose the appropriate level of complexity for each patient evaluation.We are glad you asked.There are four main evaluation complexity factors.

Before we dive into the defining characteristics of each complexity level, let’s define a few terms.

Hopefully this breakdown will make it easier to choose the right level of complexity.Your documentation should always support your coding choices, as clinical judgement plays a huge role in code selection.If you are still confused by the new codes, leave a question in the comment section below.We will try to find an answer.

If you enter your email address below, we will send you a chart to help you decide which level of complexity is appropriate for any given patient evaluation.

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The content marketing manager is Brooke Andrus.She has seven years of experience in content marketing.