Coding & Billing

New Occupational Therapy Evaluation and Re-Evaluation Codes (Effective January 1, 2017)
EDUCATIONAL RESOURCES AVAILABLE NOW

New occupational therapy CPT® evaluation and re-evaluation codes under the Physical Medicine and Rehabilitation section of the CPT® Manual have replaced existing CPT® codes 97003 and 97004. Get member educational resources associated with proper use of the new evaluation codes (more resources coming soon!).

VIEW CPT® EVALUATION CODES RESOURCES

ICD-10 Resources

The new ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) system, replaced the ICD-9-CM (9th Revision) on October 1, 2015. AOTA developed the following resources to help occupational therapists prepare for the implementation deadline.

VIEW ICD-10 CODING RESOURCES

• Selected Occupational Therapy CPT© Codes - pdf 
• Medicare Correct Coding Initiative and Medically Unlikely Edits
• CMS Medicare Physician Fee Schedule Calculator

• Selected HCPCS Level II Codes - pdf 

• Medicare Part B Functional Reporting Requirements 
• Resources for G Code Functional Data Reporting 

• Occupational Therapists Should Continue Modifier 59 Use
• CMS MLN Matters Article SE1418: Proper Use of Modifier 59
• Medicare Claim Review Programs: MR, NCCI Edits, MUEs, CERT, and RAC
• Medicare Learning Network (MLN) Medicare Outpatient Therapy Billing (CMS. Aug. 2010)

For additional assistance with payment and reimbursement issues, contact AOTA’s Regulatory Affairs department at regulatory@aota.org.