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An occupational therapy re-evaluation (CPT® Code 97004) is a critical component of the occupational therapy process, aimed at assessing a patient's progress and adjusting their treatment plan as necessary. This procedure follows an initial occupational therapy evaluation (CPT® Code 97003) and is designed to ensure that the therapeutic interventions remain effective and relevant to the patient's evolving needs. During the re-evaluation, the occupational therapist conducts an interim history to gather updated information about the patient's condition and treatment response. This includes assessing any changes in the patient's physical, mental, and neurobehavioral status since the last evaluation. The therapist evaluates the patient's progress in regaining or developing skills necessary for independent functioning, which is essential for enhancing overall health and personal well-being. The re-evaluation process involves a thorough review of the patient's ability to perform activities of daily living (ADLs), such as dressing, bathing, and mobility, as well as instrumental activities of daily living (IADLs) like shopping, cooking, and transportation access. The occupational therapist also considers cognitive and psychosocial factors that may impact the patient's functional capabilities. Identifying barriers in various environments—home, school, work, and community—is a key aspect of this evaluation, as it helps in formulating strategies to overcome these obstacles. Additionally, the need for adaptive equipment is reassessed to ensure that the patient has the necessary tools to facilitate their independence. Following the re-evaluation, the occupational therapist provides a written report and revises the treatment plan based on the patient's current status and response to previous interventions, ensuring that the therapy remains aligned with the patient's goals and needs.
© Copyright 2025 Coding Ahead. All rights reserved.
The occupational therapy re-evaluation (CPT® Code 97004) is indicated for patients who have undergone previous occupational therapy evaluations and require an assessment of their progress and treatment effectiveness. The following conditions may warrant a re-evaluation:
The procedure for an occupational therapy re-evaluation involves several key steps to ensure a comprehensive assessment of the patient's current status and treatment needs. Each step is crucial for gathering relevant information and formulating an effective treatment plan.
After the occupational therapy re-evaluation, the patient may receive a revised treatment plan that outlines the updated goals and interventions. The occupational therapist will provide the patient with a written report summarizing the findings of the re-evaluation and the rationale for any changes made to the treatment plan. The patient is encouraged to actively participate in their therapy and communicate any concerns or challenges they may encounter during the implementation of the revised plan. Follow-up appointments may be scheduled to monitor the patient's progress and make further adjustments as needed. Continuous assessment and adaptation of the treatment plan are essential to support the patient's journey toward achieving greater independence and improved quality of life.
| Short Descr | OT RE-EVALUATION | Medium Descr | OCCUPATIONAL THERAPY RE-EVALUATION | Long Descr | Occupational therapy re-evaluation | 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 - Subject to 20%/25% reduction of the practice expense component... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - 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) | M5D - Specialist - other | MUE | Not applicable/unspecified. | CCS Clinical Classification | 212 - Diagnostic physical therapy |
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