The Centers for Medicare and Medicaid Services (CMS) has updated the list of codes that sometimes or always describe therapy codes for calendar year 2018. In 2018, 1 CPT code is being added to the “always therapy” list and 1 CPT code is being added to the “sometimes therapy” list. To learn the difference between an “always therapy” code and a “sometimes therapy” code, click HERE.
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If you made a thumb splint for a patient and billed it under 97760 and then the patient outgrows it and needs another one made and you have not discharged the patient yet (same bout of therapy) would that be billed as 97760 or 97763. Does the response change if the patient had been discharged and now comes back?
Since it’s a new orthosis, I would say 97760.