CPT code 97164 refers to a follow-up meeting with a physical therapist to review and update a patient’s therapy plan. CPT 97164 represents “Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family..”
Procedure Explanation:
This procedure involves meeting with a physical therapist who evaluates how well the current therapy plan is working for the patient. It includes a check-up on the patient’s health history, standardized tests, and possibly revising the therapy strategy using specific assessment tools. Usually, the therapist spends about 20 minutes with the patient and, if needed, their family too. It focuses only on evaluation and planning, not on providing new physical therapy sessions at this time.
Common Names:
- PT Re-evaluation
- Physical Therapy Progress Assessment
- Physiotherapy Plan Update
Relative Value Units (RVU):
The RVUs associated with this code are 0.96.
How This Procedure Appears:
- Operating Room Schedule Name: Physical Therapy Re-eval
- Surgical Consent Form Name: PT Re-evaluation Consent
Typical Patients and Diagnoses:
This procedure is commonly used for patients who are undergoing rehabilitation and need their progress reviewed. For instance, someone recovering from knee surgery might need their therapy plan checked to ensure they are improving and aren’t facing new issues. This type of appointment is suitable for anyone who requires adjustments or a fresh evaluation of their ongoing physical recovery efforts.
Associated ICD-10 Codes:
- M54.5: This code indicates lower back pain, which often needs ongoing physical therapy to help relieve discomfort and improve movement.
- M16.11: Represents unilateral primary osteoarthritis of the right hip, which might require therapy assessments to ensure effective management of mobility and pain.
- I69.351: Describes hemiplegia following a stroke, typically involving long-term physical therapy to regain as much function as possible.
Summary
In summary, code 97164 describes a physical therapy session focused on reassessing and potentially updating the patient’s treatment plan. Typical ICD-10 codes associated with 97164 include M54.5 (lower back pain) and M16.11 (osteoarthritis of the hip).
Disclaimer
This post is for informational purposes only and is not a substitute for medical advice. “CPT” and CPT Codes are registered trademarks of the American Medical Association. HCPCS codes are managed by Medicare and are not subject to copyright.