How To Use CPT Code 97763

CPT 97763 describes the management and training of orthotic and prosthetic devices for the upper extremities, lower extremities, and trunk during subsequent encounters. 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 97763?

CPT 97763 can be used to describe the management and training services provided by a healthcare professional for orthotic and prosthetic devices. This code is used during subsequent encounters when the provider meets face-to-face with the patient to manage or train them on the use of an orthotic or prosthetic device for the upper extremities, lower extremities, or trunk. Each 15 minutes spent with the patient during the subsequent encounter should be reported using this code.

2. Official Description

The official description of CPT code 97763 is: ‘Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes.’

3. Procedure

1. The healthcare professional assesses the patient’s movement and musculoskeletal abnormalities that may affect their ability to perform daily activities.
2. A comprehensive treatment plan is developed based on the assessment to enhance the patient’s functional ability.
3. The orthotic or prosthetic treatment plan is implemented, which may include fitting or refitting of the device, patient instructions, and follow-up plans.
4. During subsequent encounters, the provider meets face-to-face with the patient to manage or train them on the use of the orthotic or prosthetic device.
5. Each 15 minutes spent with the patient during the subsequent encounter should be reported using CPT code 97763.

4. Qualifying circumstances

Patients eligible to receive CPT 97763 services are those who require management and training for orthotic or prosthetic devices for the upper extremities, lower extremities, or trunk. The provider works face-to-face with the patient to improve their use of the device and enhance their functional ability. This code represents each 15 minutes of a subsequent face-to-face encounter in which the provider performs this service.

5. When to use CPT code 97763

CPT code 97763 should be used during subsequent encounters when the provider meets face-to-face with the patient to manage or train them on the use of an orthotic or prosthetic device for the upper extremities, lower extremities, or trunk. Each 15 minutes spent with the patient during the subsequent encounter should be reported using this code.

6. Documentation requirements

To support a claim for CPT 97763, the healthcare professional must document the following information:

• Patient’s assessment for movement impairment or musculoskeletal abnormalities
• Treatment plan based on the comprehensive assessment
• Implementation of the orthotic or prosthetic treatment plan
• Date and duration of each subsequent face-to-face encounter
• Details of the management or training provided during each encounter
• Signature of the healthcare professional providing the service

7. Billing guidelines

When billing for CPT 97763, ensure that the subsequent encounter is face-to-face with the patient and each 15 minutes spent with the patient is reported using this code. Do not report CPT 97763 in conjunction with CPT codes 97760 or 97761. Additional tips for reporting CPT 97763 can be found in the official documentation.

8. Historical information

CPT 97763 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates to the code since its addition.

9. Examples

1. An orthopedic specialist providing management and training for an upper extremity orthotic device during a subsequent encounter with a patient.
2. A physical therapist assisting a patient with the use of a lower extremity prosthetic device during a subsequent face-to-face session.
3. A healthcare professional managing and training a patient on the use of a trunk orthotic device during a subsequent encounter.
4. A provider working with a patient to improve their functional ability with the use of an upper extremity prosthetic device during a subsequent face-to-face session.
5. A therapist providing management and training for a lower extremity orthotic device during a subsequent encounter with a patient.
6. A healthcare professional assisting a patient with the use of a trunk prosthetic device during a subsequent face-to-face session.
7. An orthopedic specialist managing and training a patient on the use of an upper extremity orthotic device during a subsequent encounter.
8. A physical therapist working with a patient to improve their functional ability with the use of a lower extremity prosthetic device during a subsequent face-to-face session.
9. A provider providing management and training for a trunk orthotic device during a subsequent encounter with a patient.
10. A therapist assisting a patient with the use of an upper extremity prosthetic device during a subsequent face-to-face session.