Use CPT 97542 for an assessment done to evaluate the patient’s need for a wheelchair. This may include the patient’s strength, living situation, weight, skin integrity, etc.
Once the patient’s needs are established, measurements are taken prior to ordering the equipment.
For assessment and fitting, the patient’s abilities are observed, maneuverability skills are practiced and instructions are provided for adjustments to the wheelchair and wheelchair use.
Usually, the assessment(s) and fitting can be completed in 1-2 sessions. Medical necessity must support additional sessions.
Wheelchair management (CPT code 97542) also trains the patient in functional activities that promote optimal safety, mobility and transfers.
Patients who are wheelchair bound may occasionally need skilled input on positioning to avoid pressure points, contractures, and other medical complications.
Medical Necessity Of CPT 97542
CPT 97542 is medically necessary only when it requires the professional skills of a therapist, is designed to address specific needs of the patient, and may be part of an active treatment plan directed at a specific goal.
The patient must have the capacity to learn from instructions.
Typically 3-4 total sessions should be sufficient to teach the patient these skills. Medical necessity must support additional sessions.