CPT 97546 can report work conditioning for the first two hours. The add-on code 97546 can be billed for every extra hour that the service is performed.
Underneath the description, guidelines, and reimbursement for work conditioning.
Description Of The 97545 CPT Code
The manual defines CPT 97545 as: “Work hardening/conditioning. Initial 2 hours.”
Work conditioning is the general approach to getting a patient back in good work condition.
Description Of The 97546 CPT Code
CPT 97546 is an add-on code for work conditioning. After the first two hours (bill CPT 97545), the add-on code 97546 can be billed.
CPT code 97546 is described as: “Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure.”
Make sure to list CPT 97546 separately in addition to CPT code 97545.
Remember that CPT 97545 will be denied if work hardening is documented, but work conditioning is performed.
Work hardening simulates an occupation for a patient. Its main goal is to offer individual exercises to prepare the patient for a particular job.
Therefore work hardening involves specific goals, and payers will recognize that it takes longer to perform—Bill more units for more units of CPT 97545 and CPT 97546 for the specific goals.
Medicare does not reimburse work conditioning (CPT 97545 and CPT 97546). These services are related solely to specific work skills, and they are not reasonable or necessary for the diagnosis or treatment of an illness or injury and are not covered.