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Direct, one-on-one sensory integrative techniques are therapeutic interventions aimed at enhancing sensory processing and promoting adaptive responses to various environmental demands. These techniques are particularly beneficial for individuals who experience difficulties in processing sensory information, which can lead to challenges in adapting and functioning in everyday situations. Sensory integration is a critical function of the brain that allows individuals to filter and appropriately respond to sensory stimuli from their environment. When this process is disrupted, patients may exhibit sensory integration dysfunction, characterized by sensory defensiveness, over-reactions to stimuli, behavioral issues, or attention deficits. Common conditions that may warrant the use of sensory integration services include autism, developmental disorders, attention deficit disorders, cerebral palsy, and motor ataxia. The role of the occupational therapist is pivotal in this process, as they begin with a comprehensive evaluation to identify which sensory systems—such as vestibular, proprioceptive, tactile, visual, or auditory—are affected in the patient. Following this assessment, the therapist designs targeted activities aimed at helping the patient regulate their behavioral responses to sensory stimuli that may be perceived as disturbing or painful. Treatment goals are established collaboratively, and the therapeutic activities are tailored to progressively challenge the patient’s sensory processing abilities. For instance, a patient who is oversensitive to touch may start with exercises that involve light touch and gradually progress to more intense tactile experiences as their responses improve. Sensory integrative services are billed in 15-minute intervals, reflecting the direct patient contact involved in these therapeutic techniques.
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Sensory integrative techniques are indicated for patients experiencing difficulties in sensory processing and adaptive responses to environmental stimuli. These techniques are particularly relevant for the following conditions:
The procedure for implementing sensory integrative techniques involves several key steps, each designed to enhance the patient's sensory processing abilities:
After the implementation of sensory integrative techniques, the patient may require ongoing support and monitoring to assess their progress. The occupational therapist will evaluate the effectiveness of the interventions and make necessary adjustments to the treatment plan. Patients may experience varying recovery times based on their individual needs and the complexity of their sensory integration challenges. Continuous engagement in sensory integration activities may be recommended to reinforce adaptive responses and improve overall functioning in daily life. Additionally, caregivers may be provided with strategies to support the patient outside of therapy sessions, ensuring a comprehensive approach to sensory integration.
| Short Descr | SENSORY INTEGRATION | Medium Descr | SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES | Long Descr | Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 7 - Physical Therapy Service, for which Payment may not be Made | Multiple Procedures (51) | 5 - Special payment adjustment rules on the RVU practice expense component of multiple therapy service applies... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Service Paid under Fee Schedule or Payment System other than OPPS | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 4 | CCS Clinical Classification | 215 - Other physical therapy and rehabilitation |
This is a primary code that can be used with these additional add-on codes.
| 0770T | Add-on Code MPFS Status: Carrier Priced APC E1 Virtual reality technology to assist therapy (List separately in addition to code for primary procedure) |
| GO | Services delivered under an outpatient occupational therapy plan of care | GA | Waiver of liability statement issued as required by payer policy, individual case | GP | Services delivered under an outpatient physical therapy plan of care | KX | Requirements specified in the medical policy have been met | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | GZ | Item or service expected to be denied as not reasonable and necessary | GN | Services delivered under an outpatient speech language pathology plan of care | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | GX | Notice of liability issued, voluntary under payer policy | GW | Service not related to the hospice patient's terminal condition | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AJ | Clinical social worker | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GT | Via interactive audio and video telecommunication systems | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Description Changed |
| 2001-01-01 | Added | First appearance in code book in 2001. |
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