Therapeutic Exercise vs Therapeutic Activities: What’s the Difference?
If you were to ask your clinical staff if they have their patients do functional activities for 15-30 minutes during a therapy visit, my experience as a consultant tells me 100% of them would say yes. Yet, if I were to review the percentage of 97530 units billed in a calendar month, my experience tells me that percentage is under 10% and many times, under 5%.
Why is that? In my opinion, therapists and assistants do not fully understand what interventions are included within the therapeutic activities CPT code and how to document to support billing therapeutic activities and they then just tend to lump all of the billable minutes under therapeutic exercise.
In this article, I will provide answers to the following questions:
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Thanks for the article as these 2 codes can be complicated as 97530 seems to be “the belle of the ball”
I’m around a lot of settings with travel and am curious about “when” therapeutic activity becomes therapeutic exercise. Sit to stands, step training, squats, lunges are all functional activity. Leg presses on a machine or a Pilates reformer “to improve bending to the ground for gardening” is functional.
But, when the patients have been performing these activities for several weeks/months, I would think that the lesser paying therapeutic exercise would be the more appropriate code as strengthening is the purpose. TA is being forced because it is “functional”. How would you continue to bill TA? Lots of vc’s as indicated in article?
Thanks
The therapist needs to make that determination based on their intent and their documentation in the medical record.