How To Use CPT Code 97535

CPT 97535 describes the instruction and training provided by a healthcare provider to a patient for self-care and home management. 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 97535?

CPT 97535 can be used to describe the instruction and training services provided by a healthcare provider to a patient for self-care and home management. This code is used when the provider has direct one-on-one contact with the patient, focusing on activities of daily living (ADL) such as walking, eating, dressing, and more.

2. Official Description

The official description of CPT code 97535 is: ‘Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes.’

3. Procedure

1. A healthcare provider provides direct one-on-one instruction and training to the patient for self-care and home management.
2. The instruction focuses on activities of daily living (ADL) such as walking, eating, dressing, and more.
3. Compensatory training may be provided to help the patient adapt to any limitations or disabilities.
4. Meal preparation instructions may be given to ensure the patient can safely and independently prepare their meals.
5. Safety procedures are taught to the patient to prevent accidents and promote a safe living environment.
6. Instructions on the use of assistive technology devices or adaptive equipment may be provided to enhance the patient’s independence and quality of life.
7. The instruction and training are provided through direct one-on-one contact with the patient, with each session lasting 15 minutes.
8. Additional sessions may be scheduled as needed to address the patient’s specific needs and goals.

4. Qualifying circumstances

Patients eligible to receive CPT 97535 services are those who require instruction and training for self-care and home management. This may include individuals recovering from acute diseases or those with limitations or disabilities that affect their ability to perform activities of daily living (ADL). The instruction and training must be provided by a healthcare provider through direct one-on-one contact with the patient, focusing on activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and the use of assistive technology devices/adaptive equipment.

5. When to use CPT code 97535

CPT code 97535 should be used when a healthcare provider provides direct one-on-one instruction and training to a patient for self-care and home management. This code is appropriate for each 15-minute session provided to the patient. It is important to note that CPT code 97535 should not be reported for services that are not focused on self-care and home management training.

6. Documentation requirements

To support a claim for CPT 97535, the healthcare provider must document the following information:

• Patient’s need for self-care and home management training
• Specific activities of daily living (ADL) and compensatory training provided
• Date, start and end time of each 15-minute session
• Instructions given for meal preparation, safety procedures, and use of assistive technology devices/adaptive equipment
• Progress made by the patient and any additional sessions scheduled
• Signature of the healthcare provider providing the service

7. Billing guidelines

When billing for CPT 97535, ensure that the instruction and training are provided through direct one-on-one contact with the patient, focusing on activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and the use of assistive technology devices/adaptive equipment. Report each 15-minute session separately using CPT code 97535. It is important to note that CPT code 97535 should not be reported with other codes that do not involve self-care and home management training.

8. Historical information

CPT 97535 was added to the Current Procedural Terminology system on January 1, 1996. There have been several changes to the code over the years, with the most recent change occurring on January 1, 2013.

9. Examples

1. A physical therapist providing instruction and training to a patient recovering from a stroke on how to dress independently during a 15-minute session.
2. An occupational therapist teaching a patient with a spinal cord injury how to use adaptive equipment for meal preparation during a 15-minute session.
3. A speech therapist providing instruction and training to a patient with a traumatic brain injury on safety procedures for swallowing during a 15-minute session.
4. A rehabilitation nurse teaching a patient with multiple sclerosis compensatory techniques for walking during a 15-minute session.
5. A physical therapist providing instruction and training to a patient with arthritis on the use of assistive devices for mobility during a 15-minute session.
6. An occupational therapist teaching a patient with a hand injury how to perform activities of daily living (ADL) using adaptive techniques during a 15-minute session.
7. A speech therapist providing instruction and training to a patient with Parkinson’s disease on exercises to improve speech clarity during a 15-minute session.
8. A rehabilitation nurse teaching a patient with a spinal cord injury how to perform transfers safely during a 15-minute session.
9. A physical therapist providing instruction and training to a patient with a hip replacement on exercises to improve range of motion during a 15-minute session.
10. An occupational therapist teaching a patient with a traumatic brain injury how to use assistive technology devices for communication during a 15-minute session.