How To Use CPT Code 1175F

CPT 1175F describes the assessment of functional status for patients with dementia and the review of the results. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 1175F?

CPT 1175F can be used to report the assessment of functional status for patients with dementia and the review of the results. This code is used when a provider evaluates the patient’s ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) to determine their functional capacity.

2. Official Description

The official description of CPT code 1175F is: ‘Functional status for dementia assessed and results reviewed (DEM).’ This code includes the assessment of the patient’s physical and mental functioning, behavior patterns, ADL, and IADL. It also encompasses the review of the results of the functional status assessment.

3. Procedure

1. The provider assesses the functional status of a patient with dementia, including their ADL and IADL.
2. The provider uses various measurement concepts and tools to evaluate the patient’s ability to function normally and carry out their daily activities.
3. The provider documents the results of the functional status assessment in the patient’s healthcare record.
4. The provider reviews the results of the assessment to analyze the patient’s plan of care.

4. Qualifying circumstances

CPT 1175F is applicable for patients with dementia, which refers to a disorder characterized by cognitive and functional impairment. The assessment of functional status is crucial in determining the patient’s ability to perform ADL and IADL. The provider must document the results of the assessment and review them to understand the patient’s level of functioning and plan appropriate care.

5. When to use CPT code 1175F

CPT code 1175F should be used when assessing the functional status of patients with dementia and reviewing the results. It is important to note that this code should be reported at least once within a 12-month period. However, it should not be reported if the same assessment has been performed within the previous seven days using CPT codes 98966 to 98968.

6. Documentation requirements

To support a claim for CPT 1175F, the provider must document the following information:

• Results of the functional status assessment, including the patient’s ADL and IADL
• Date of the assessment
• Review of the assessment results
• Signature of the provider performing the assessment

7. Billing guidelines

When billing for CPT 1175F, ensure that the assessment is performed for patients with dementia and the results are reviewed. It is important to follow the specific documentation requirements and guidelines for reporting this code. Additionally, consider any applicable modifiers or reporting instructions provided by payers to ensure accurate billing.

8. Historical information

CPT 1175F was added to the Current Procedural Terminology system on January 1, 2012. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider assesses the functional status of a patient with dementia, including their ability to perform ADL and IADL. The results are reviewed to determine the appropriate plan of care.
2. During an evaluation, a provider assesses the patient’s cognitive and functional impairment, documenting their level of functioning in ADL and IADL. The results are reviewed to guide the patient’s treatment and support services.
3. A healthcare professional evaluates a patient with dementia, assessing their ability to manage finances, medications, and shopping. The results of the assessment are reviewed to determine the patient’s functional capacity and plan appropriate interventions.
4. As part of a comprehensive evaluation, a provider assesses the functional status of a patient with dementia, including their ability to perform tasks such as bathing, dressing, and toileting. The results are reviewed to develop a personalized care plan.
5. During a routine assessment, a provider evaluates the functional status of a patient with dementia, focusing on their ability to prepare meals, do housework, and handle finances. The results of the assessment are reviewed to determine the patient’s level of independence and support needs.
6. A healthcare professional conducts a functional status assessment for a patient with dementia, evaluating their ability to use public transportation, use the telephone, and take medications independently. The results are reviewed to determine the patient’s functional capacity and support requirements.
7. As part of an ongoing care plan, a provider assesses the functional status of a patient with dementia, focusing on their ability to manage their personal hygiene and continence. The results of the assessment are reviewed to monitor the patient’s progress and make necessary adjustments to their care.
8. A provider evaluates the functional status of a patient with dementia, assessing their ability to transfer from bed to wheelchair and perform other mobility-related tasks. The results are reviewed to determine the patient’s level of independence and the need for assistive devices or support.
9. During a comprehensive assessment, a healthcare professional evaluates the functional status of a patient with dementia, focusing on their ability to engage in social activities and maintain relationships. The results of the assessment are reviewed to develop a person-centered care plan.
10. A provider assesses the functional status of a patient with dementia, evaluating their ability to manage their medications and follow a prescribed treatment regimen. The results of the assessment are reviewed to ensure the patient’s adherence to the recommended care plan.