How To Use CPT Code 0373T

CPT 0373T describes the administration of adaptive behavior treatment with protocol modification by two or more technicians, under the direction of an on-site physician or other qualified healthcare professional, for a patient with severe destructive behaviors. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0373T?

CPT 0373T can be used to describe the administration of adaptive behavior treatment with protocol modification for a patient with severe destructive behaviors. This code is used when two or more technicians, under the direction of an on-site physician or other qualified healthcare professional, provide face-to-face time with the patient to address specific severe destructive behaviors, such as self-injurious behavior, aggression, or property destruction.

2. Official Description

The official description of CPT code 0373T is: ‘Adaptive behavior treatment with protocol modification, each 15 minutes of technicians’ time face-to-face with a patient, requiring the following components: administration by the physician or other qualified health care professional who is on site; with the assistance of two or more technicians; for a patient who exhibits destructive behavior; completion in an environment that is customized to the patient’s behavior.’

3. Procedure

1. The on-site physician or qualified healthcare professional assesses the patient’s severe destructive behaviors and determines the need for adaptive behavior treatment with protocol modification.
2. A team of two or more technicians is assembled to provide the treatment under the direction of the physician or qualified healthcare professional.
3. The treatment is administered in a customized environment that ensures the safety of the patient and the technicians.
4. The technicians provide face-to-face time with the patient, addressing specific severe destructive behaviors through various techniques, such as real-time observation, blocking attempts at self-injurious behavior, and teaching alternative communication methods.
5. The physician or qualified healthcare professional reviews and analyzes data, making modifications or replacements to the treatment plan as necessary to achieve the patient’s goals.
6. The treatment is rendered in structured, safe sessions based on 15-minute increments of technician face-to-face time with the patient.

4. Qualifying circumstances

Patients eligible to receive CPT 0373T services are those who exhibit severe destructive behaviors, such as self-injurious behavior, aggression, or property destruction. The treatment must be administered by an on-site physician or other qualified healthcare professional, with the assistance of two or more technicians. The treatment is completed in an environment that is customized to the patient’s behavior, ensuring their safety and the safety of the technicians.

5. When to use CPT code 0373T

CPT code 0373T should be used when a patient exhibits severe destructive behaviors that require adaptive behavior treatment with protocol modification. This code should be reported for each 15 minutes of face-to-face time that the technicians spend with the patient. It should not be reported in conjunction with codes 90785-90899, 96105, 96110, 96116, 96121, 96156, 96158, 96159, 96164, 96165, 96167, 96168, 96170, or 96171.

6. Documentation requirements

To support a claim for CPT 0373T, the following documentation is required:

• Patient’s diagnosis and the need for adaptive behavior treatment with protocol modification
• Description of the specific severe destructive behaviors being addressed
• Date and duration of each 15-minute face-to-face session with the patient
• Details of the treatment provided, including techniques used and progress made
• Signature of the on-site physician or qualified healthcare professional overseeing the treatment

7. Billing guidelines

When billing for CPT 0373T, ensure that the treatment is administered by an on-site physician or qualified healthcare professional, with the assistance of two or more technicians. The treatment should be completed in a customized environment that is tailored to the patient’s behavior. It should not be reported in conjunction with certain other codes. Follow the appropriate guidelines for reporting and ensure accurate documentation to support the claim.

8. Historical information

CPT 0373T was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates to the code since its addition. Previously, the code was described as ‘Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s); first 60 minutes of technicians’ time, face-to-face with patient.’

9. Examples

1. A team of technicians, under the direction of an on-site physician, providing adaptive behavior treatment with protocol modification for a patient with self-injurious behavior.
2. Two technicians working closely with a patient who exhibits aggressive behavior, using modeling and reinforcement techniques to teach the patient alternative communication methods.
3. Three technicians providing continuous real-time data collection, blocking attempts at self-injurious behavior, and teaching a patient to request attention using a short phrase.
4. A physician overseeing the treatment of a patient with property destruction behaviors, modifying the therapy based on single case designs to achieve the desired outcomes.
5. Technicians rendering treatment in a structured, safe environment, such as a padded room, while wearing protective gear due to the patient’s dangerous behavior.
6. Multiple technicians working with a patient who uses violent behavior to avoid tasks, collecting data on self-injurious behavior, aggression, and communication responses.
7. A team of technicians providing adaptive behavior treatment with protocol modification for a patient with severe destructive behaviors, such as aggression and property destruction.
8. Technicians administering treatment in a customized environment that ensures the patient’s safety and addresses their specific severe destructive behaviors.
9. A physician or qualified healthcare professional analyzing data and refining the therapy to achieve the discharge goals for a patient with self-injurious behavior.
10. Technicians providing face-to-face time with a patient, addressing specific severe destructive behaviors through real-time observation and teaching alternative communication methods.