How To Use CPT Code 97129

CPT 97129 focuses on therapeutic interventions for cognitive function and compensatory strategies, with this article covering topics such as the code description, procedure, qualifying circumstances, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 97129?

CPT 97129 is a medical billing code used to describe therapeutic interventions that focus on cognitive function and compensatory strategies. These interventions aim to improve a patient’s cognitive abilities, such as attention, memory, reasoning, executive function, problem-solving, and pragmatic functioning. The code is used for billing purposes when a healthcare provider works directly with a patient to help them develop or improve these cognitive skills and compensatory strategies to manage the performance of an activity.

2. 97129 CPT code description

The official description of CPT code 97129 is: “Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem-solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; initial 15 minutes.”

3. Procedure

1. The healthcare provider assesses the patient’s cognitive function and identifies areas that require improvement.
2. The provider develops a personalized therapeutic intervention plan to address the patient’s specific cognitive needs and compensatory strategies.
3. The provider works one-on-one with the patient, implementing the therapeutic intervention plan and providing guidance and support.
4. Progress is monitored and adjustments are made to the intervention plan as needed.
5. The provider documents the patient’s progress and any changes to the intervention plan.

4. Qualifying circumstances

Patients eligible to receive CPT code 97129 services are those who have demonstrated difficulties in cognitive function and require therapeutic interventions to improve their abilities. This may include patients with learning disabilities, traumatic brain injuries, neurodegenerative disorders, or other conditions that impact cognitive function. The healthcare provider must determine that the patient would benefit from these interventions and that the services are medically necessary.

5. When to use CPT code 97129

It is appropriate to bill the 97129 CPT code when a healthcare provider has assessed a patient’s cognitive function, determined that therapeutic interventions are necessary, and provided one-on-one direct patient contact for the initial 15 minutes of the intervention. The code should only be used for the first 15 minutes of the intervention, with additional time billed using CPT code 97130.

6. Documentation requirements

To support a claim for CPT 97129, healthcare providers must document the following information:

• A comprehensive assessment of the patient’s cognitive function and the specific areas requiring improvement.
• A detailed therapeutic intervention plan, including the goals and objectives of the intervention, the specific strategies to be used, and the expected outcomes.
• Documentation of the one-on-one direct patient contact, including the date, duration, and specific interventions provided during the session.
• Progress notes detailing the patient’s response to the interventions, any adjustments made to the intervention plan, and the patient’s progress towards achieving the goals and objectives.

7. Billing guidelines

When billing for CPT code 97129, healthcare providers should ensure that they have met the documentation requirements and that the services provided are medically necessary. Additionally, providers should be aware that CPT code 97129 should only be billed once per day and only for the initial 15 minutes of one-on-one direct patient contact. For each additional 15 minutes of direct patient contact, providers should bill CPT code 97130.

8. Historical information

CPT 97129 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates to the code since its addition.

9. Similar codes to CPT 97129

Five similar codes to CPT 97129 include:

1. CPT 97130: This code is used for each additional 15 minutes of one-on-one direct patient contact providing cognitive, executive, and compensatory therapeutic interventions, in addition to CPT 97129 for the first 15 minutes.
2. CPT 97110: This code is used for therapeutic exercises to develop strength, endurance, range of motion, and flexibility.
3. CPT 97112: This code is used for neuromuscular reeducation of movement, balance, coordination, and posture.
4. CPT 97116: This code is used for gait training, including the use of assistive devices and prosthetics.
5. CPT 97532: This code is used for cognitive skills development, focusing on attention, memory, and problem-solving.

10. Examples

Here are 10 detailed examples of CPT code 97129 procedures:

1. A patient with a traumatic brain injury receives one-on-one therapeutic interventions to improve memory and attention skills.
2. A patient with Alzheimer’s disease works with a provider to develop compensatory strategies for managing daily tasks and schedules.
3. A patient with a learning disability receives direct support to improve executive function and problem-solving abilities.
4. A patient recovering from a stroke works with a provider to enhance reasoning and cognitive skills.
5. A patient with attention deficit hyperactivity disorder (ADHD) receives therapeutic interventions to improve focus and organization skills.
6. A patient with autism spectrum disorder works with a provider to develop pragmatic functioning and social skills.
7. A patient with multiple sclerosis receives one-on-one support to improve cognitive function and compensatory strategies for managing daily activities.
8. A patient with Parkinson’s disease works with a provider to enhance executive function and problem-solving abilities.
9. A patient with a developmental disability receives therapeutic interventions to improve cognitive skills and adaptive functioning.
10. A patient with a brain tumor works with a provider to develop compensatory strategies for managing cognitive challenges and daily tasks.