2023 | CPT 97533 (Therapeutic Procedure)

CPT code 97533 can be reported for the development of cognitive skills to improve attention, memory, or problem-solving, may be medially necessary for patients having neurologic conditions such as head injury or trauma, stroke, muscular dystrophy and/or multiple sclerosis, or other neurological diseases.

It is inappropriate for patients with chronic, progressive, or stable brain conditions who do not have the potential for improving or restoring current cognitive function.

Description of CPT 97533: “Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes.”

Medical Necessity Of CPT 97533

The patient’s progress should be assessed every 2-3 months, showing significant and measurable improvement.

These procedures may be medically necessary when included in a patient’s individual treatment plan aimed at improving or restoring specific functions which were impaired by an identified illness or injury and when the patient’s improved functional physical/cognitive abilities that are expected to be achieved are specified in the plan.

Suppose at any time during the treatment period, it becomes evident that continued cognitive rehabilitation is not likely to be effective, that the service is no longer needed, or that all realistic, attainable goals have been met. In that case, the treatment should be discontinued.

The patient must have the capacity to learn from instructions.

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