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AOTA's Coding Proposal to AMA

The “Heart” of AOTA’s Coding Proposal

AOTA’s coding proposal includes three evaluation codes that describe different levels of patient severity and occupational therapist work complexity. In addition, the following six core codes would be used to describe the primary focus of an OT intervention during one session. Other CPT codes that have not been bundled into these core codes also would be available for reporting additional services. The core intervention codes are based on terminology used in the International Classification of Functioning, Disability, and Health (ICF).

Core Therapy Services

Intervention code 1. Therapeutic interventions that address impairments of body structure or body function (e.g., balance, mobility, strength, endurance, fine or gross motor coordination, dexterity), including therapeutic exercise, neuromuscular reeducation, orthotic and prosthetic training, and vestibular rehabilitation.

Intervention code 2. Therapeutic interventions that address use of sensation and sensory processing methods (e.g., pain, vision, touch, speech, perception).

Intervention code 3. Therapeutic interventions that address mental functions and social skills (e.g., communication, interpersonal relationships, behavior patterns, psychological demands).

Intervention code 4. Therapeutic interventions that address use of cognitive strategies, actions, or behaviors to plan and manage the performance of an activity (e.g., problem solving, concept formation, memory, planning, and executive function).

Intervention code 5. Therapeutic interventions that address the ability to perform activities of daily living (ADLs) (e.g., self-care, home management and safety, compensatory training, medication management, and training in use of assistive technology/adaptive equipment and wheelchair).

Intervention code 6. Therapeutic interventions that address the ability to perform instrumental activities of daily living (IADLs) and participate in necessary activities in the wider community (e.g. driving and access to transportation, community mobility, wheelchair training, environment modification).