How To Use CPT Code 97112

CPT 97112 describes the therapeutic procedure of neuromuscular reeducation for movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 97112?

CPT 97112 is a code used to describe a therapeutic procedure known as neuromuscular reeducation. This procedure focuses on improving movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities. It is typically performed by a physician and aims to reduce impairments and restore function through the application of clinical skills and services.

2. Official Description

The official description of CPT code 97112 is: ‘Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities.’

3. Procedure

1. The physician assesses the patient’s condition and determines the need for neuromuscular reeducation.
2. A treatment plan is developed, focusing on specific areas that require improvement in movement, balance, coordination, kinesthetic sense, posture, and/or proprioception.
3. The patient undergoes a series of exercises and activities designed to target the identified areas of improvement.
4. The physician provides direct patient-to-provider contact, demonstrating and guiding the patient through the prescribed exercises.
5. The patient performs the exercises under the constant supervision of the skilled physical therapist.
6. The exercises aim to increase mobility, enhance nerve-muscle coordination, improve balance, and develop better kinesthesia.
7. The duration of each session is typically 15 minutes, and multiple sessions may be required to achieve the desired outcomes.

4. Qualifying circumstances

CPT 97112 is applicable to patients who require neuromuscular reeducation for movement, balance, coordination, kinesthetic sense, posture, and/or proprioception. This procedure is often used for individuals with chronic pain, muscle or joint impairments, or those recovering from injuries or surgeries. It is important that the exercises are performed under the direct supervision of a skilled physical therapist to ensure safety and effectiveness.

5. When to use CPT code 97112

CPT code 97112 should be used when a patient undergoes a therapeutic procedure involving neuromuscular reeducation for movement, balance, coordination, kinesthetic sense, posture, and/or proprioception. It is appropriate to bill this code for each 15-minute session provided to the patient. However, it is important to note that CPT code 97112 should not be reported if other codes, such as CPT codes 97110 to 97546, have already been performed in the previous seven days.

6. Documentation requirements

To support a claim for CPT 97112, the physician must document the following information:

• Patient’s diagnosis and the need for neuromuscular reeducation
• Specific areas targeted for improvement
• Date and duration of each session
• Details of the exercises and activities performed
• Progress made by the patient and any additional sessions scheduled
• Signature of the physician providing the service

7. Billing guidelines

When billing for CPT 97112, ensure that the procedure is performed by a physician and that the duration of each session is 15 minutes. It is important to follow the appropriate coding guidelines and not report CPT 97112 if other related codes have already been performed within the previous seven days. Additionally, consider the location of the service and any modifiers that may be required for accurate billing.

8. Historical information

CPT 97112 was added to the Current Procedural Terminology system on January 1, 1990. Since its addition, there have been two code changes, with the most recent change occurring on January 1, 2010. The code has remained unchanged since then.

9. Examples

1. A patient recovering from knee surgery undergoing neuromuscular reeducation exercises to improve balance and coordination for standing activities.
2. An individual with chronic back pain receiving therapeutic treatment to reeducate their muscles and improve posture during sitting activities.
3. A stroke survivor undergoing neuromuscular reeducation to regain movement and coordination in their affected limbs for daily activities.
4. A patient with Parkinson’s disease participating in exercises to enhance kinesthetic sense and proprioception for improved mobility and balance.
5. An athlete rehabilitating from an ankle injury engaging in neuromuscular reeducation exercises to regain strength and stability for sports-specific activities.
6. A patient with multiple sclerosis undergoing therapeutic treatment to improve movement and coordination for sitting and standing activities.
7. An individual with a vestibular disorder receiving neuromuscular reeducation to enhance balance and coordination for walking and other daily activities.
8. A person with a spinal cord injury participating in exercises to reeducate their muscles and improve kinesthetic sense and proprioception for sitting and standing activities.
9. A patient with a traumatic brain injury undergoing therapeutic treatment to improve movement, balance, and coordination for various activities of daily living.
10. An older adult with age-related balance issues engaging in neuromuscular reeducation exercises to enhance stability and reduce the risk of falls during standing activities.