How To Use CPT Code 97113

CPT 97113 refers to aquatic therapy with therapeutic exercises, a procedure that involves instructing and supervising a patient in water-based therapeutic exercises. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 97113.

1. What is CPT 97113?

CPT 97113 is a code used to describe aquatic therapy with therapeutic exercises. This procedure involves a healthcare provider instructing and supervising a patient in performing therapeutic exercises in a water environment, such as a pool or whirlpool. The purpose of aquatic therapy is to reduce impairments and restore function through the application of clinical skills and services in a water-based setting.

2. 97113 CPT code description

The official description of CPT code 97113 is: “Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises.”

3. Procedure

  1. The healthcare provider assesses the patient’s condition and determines the appropriate aquatic therapy exercises.
  2. The patient enters the water environment, such as a pool or whirlpool.
  3. The provider instructs the patient on how to perform the therapeutic exercises, demonstrating each movement as needed.
  4. The patient follows the provider’s instructions and performs the exercises in the water.
  5. The provider supervises the patient throughout the entire session, ensuring proper technique and safety.
  6. The session lasts for a minimum of 15 minutes, with additional 15-minute increments as needed.

4. Qualifying circumstances

Patients who are eligible to receive CPT 97113 services are those with medical conditions that can benefit from aquatic therapy. These conditions may include, but are not limited to, musculoskeletal disorders, neurological disorders, post-surgical rehabilitation, and chronic pain. The patient’s healthcare provider must determine that aquatic therapy is medically necessary and appropriate for the patient’s specific condition.

5. When to use CPT code 97113

It is appropriate to bill CPT code 97113 when a healthcare provider instructs and supervises a patient in performing therapeutic exercises in a water environment for the purpose of reducing impairments and restoring function. The provider must determine that aquatic therapy is medically necessary and appropriate for the patient’s specific condition. The session must last for a minimum of 15 minutes, with additional 15-minute increments as needed.

6. Documentation requirements

Documentation supporting a claim for CPT 97113 must include the following information:

  • A detailed description of the patient’s medical condition and the reason for aquatic therapy.
  • A clear explanation of the specific therapeutic exercises performed during the session.
  • The duration of the session, including the number of 15-minute increments.
  • Progress notes indicating the patient’s response to the therapy and any changes in their condition.
  • A plan for future aquatic therapy sessions, if applicable.

7. Billing guidelines

When billing for CPT 97113, keep in mind the following guidelines:

  • Bill for each 15-minute increment of aquatic therapy provided.
  • Do not bill for the water modality used to provide the aquatic environment, such as whirlpool (97022), in addition to 97113.
  • Ensure that documentation supports the medical necessity of aquatic therapy.

8. Historical information

CPT 97113 was added to the Current Procedural Terminology system on January 1, 1995. The code was changed on January 1, 2010, with the previous descriptor being “Therapeutic procedure, one or more areas, each 15 minutes; aquatic therapy with therapeutic exercises.”

9. Similar codes to CPT 97113

Five similar codes to CPT 97113 include:

  • CPT 97110: Therapeutic exercises, which differ from CPT 97113 as they are not performed in a water environment.
  • CPT 97112: Neuromuscular reeducation, focusing on retraining movement patterns rather than aquatic exercises.
  • CPT 97116: Gait training, which specifically targets walking and mobility rather than general therapeutic exercises in water.
  • CPT 97140: Manual therapy techniques, involving hands-on manipulation of soft tissue and joints, not aquatic exercises.
  • CPT 97530: Therapeutic activities, which are functional, dynamic tasks rather than water-based exercises.

10. Examples

  1. A patient with a recent knee surgery undergoing aquatic therapy to regain strength and range of motion.
  2. A patient with chronic low back pain participating in aquatic therapy to improve core strength and flexibility.
  3. A patient with multiple sclerosis engaging in aquatic therapy to improve balance and coordination.
  4. A patient recovering from a stroke participating in aquatic therapy to regain functional movement.
  5. A patient with fibromyalgia undergoing aquatic therapy to manage pain and improve overall function.
  6. A patient with a hip replacement participating in aquatic therapy to regain mobility and strength.
  7. A patient with rheumatoid arthritis engaging in aquatic therapy to improve joint flexibility and reduce pain.
  8. A patient with a spinal cord injury undergoing aquatic therapy to improve muscle strength and function.
  9. A patient with Parkinson’s disease participating in aquatic therapy to improve balance and coordination.
  10. A patient with a sports injury engaging in aquatic therapy to facilitate rehabilitation and return to activity.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *