How To Use CPT Code 97545

CPT 97545 describes the initial two hours of a work hardening/conditioning program. 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 97545?

CPT 97545 can be used to report the initial two hours of a work hardening/conditioning program. This program is designed to help patients increase their strength and improve their physical condition in order to facilitate their safe return to work after an injury. The program utilizes various techniques to enhance neuromuscular efficiency, cardiovascular endurance, and flexibility. During the initial two-hour session, the provider guides the patient through real or simulated work tasks and educates them on workplace safety and injury prevention.

2. Official Description

The official description of CPT code 97545 is: ‘Work hardening/conditioning; initial 2 hours.’

3. Procedure

1. The provider assesses the patient’s physical condition and determines the need for a work hardening/conditioning program.
2. A structured treatment program is developed, tailored to the patient’s specific needs and work requirements.
3. The patient undergoes a two-hour session, during which they engage in activities and exercises that mimic their work tasks.
4. The provider monitors the patient’s progress, provides guidance on proper techniques, and educates them on workplace safety and injury prevention.
5. Additional sessions may be scheduled as needed to further enhance the patient’s physical abilities and prepare them for a safe return to work.

4. Qualifying circumstances

CPT 97545 is appropriate for patients who require a work hardening/conditioning program to facilitate their return to work after an injury. The program is designed to improve the patient’s strength, neuromuscular efficiency, cardiovascular endurance, and flexibility. The patient must be under the care of a provider who can guide them through the program and educate them on workplace safety. The initial two-hour session is reported using CPT code 97545.

5. When to use CPT code 97545

CPT code 97545 should be used to report the initial two-hour session of a work hardening/conditioning program. This code is appropriate when the provider guides the patient through activities and exercises that simulate their work tasks and educates them on workplace safety. If additional hours are provided in subsequent sessions, the +97546 code should be used to report each additional hour.

6. Documentation requirements

To support a claim for CPT 97545, the provider must document the following information:

• Patient’s diagnosis and the need for a work hardening/conditioning program
• Description of the structured treatment program developed for the patient
• Date, start and end time of the two-hour session
• Activities and exercises performed during the session
• Progress made by the patient and any additional sessions scheduled
• Signature of the provider delivering the service

7. Billing guidelines

When billing for CPT 97545, ensure that the service provided is the initial two-hour session of a work hardening/conditioning program. It is important to accurately report the time spent with the patient. If additional hours are provided in subsequent sessions, use the +97546 code to report each additional hour. Take note of any specific guidelines provided by payers regarding the use of this code. It is also important to consider any bundling or unbundling rules that may apply when reporting this code with other services.

8. Historical information

CPT 97545 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates or changes to the code since its addition.

9. Examples

1. A physical therapist guiding a patient through a two-hour work hardening/conditioning session that involves lifting and carrying objects to prepare them for their job as a warehouse worker.
2. An occupational therapist leading a patient through a two-hour work hardening/conditioning session that includes simulated typing and computer tasks to help them return to their desk job.
3. A rehabilitation specialist supervising a patient during a two-hour work hardening/conditioning session that focuses on repetitive bending and lifting exercises to prepare them for their role as a construction worker.
4. A certified athletic trainer conducting a two-hour work hardening/conditioning session that involves running, jumping, and agility drills to help an athlete recover from an injury and return to their sport.
5. A physical therapist assisting a patient in a two-hour work hardening/conditioning session that includes pushing and pulling activities to prepare them for their job as a delivery driver.
6. A chiropractor overseeing a patient’s two-hour work hardening/conditioning session that involves stretching and strengthening exercises to facilitate their return to their physically demanding job as a landscaper.
7. A sports medicine physician supervising a patient during a two-hour work hardening/conditioning session that focuses on sport-specific movements and drills to help them regain their athletic abilities after an injury.
8. A certified hand therapist guiding a patient through a two-hour work hardening/conditioning session that includes gripping and fine motor tasks to prepare them for their job as a jewelry maker.
9. A physical therapist leading a patient through a two-hour work hardening/conditioning session that involves stair climbing and balance exercises to help them return to their job as a firefighter.
10. An occupational therapist supervising a patient during a two-hour work hardening/conditioning session that focuses on reaching and grasping activities to prepare them for their role as a warehouse picker.