CPT® Code 97172

Official Description

Re-evaluation of athletic training established plan of care requiring these components:

An assessment of patient's current functional status when there is a documented change; and
A revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome with an update in management options, goals, and interventions.

Typically, 20 minutes are spent face-to-face with the patient and/or family.

Common Language Description

The CPT® Code 97172 refers to the re-evaluation of an established athletic training plan of care. This procedure is essential for assessing a patient's current functional status, particularly when there has been a documented change in their condition. The re-evaluation process involves two critical components: first, an assessment of the patient's current functional status, which is necessary to determine how the patient's condition has evolved since the last evaluation; and second, the development of a revised plan of care. This revised plan utilizes a standardized patient assessment instrument and/or measurable assessments of functional outcomes, ensuring that the management options, goals, and interventions are updated accordingly. Typically, this procedure requires approximately 20 minutes of face-to-face interaction with the patient and/or their family, allowing for a thorough discussion of the patient's progress and any necessary adjustments to their treatment plan.

1. Indications

The re-evaluation of an athletic training plan of care using CPT® Code 97172 is indicated in the following scenarios:

Documented Change in Condition A re-evaluation is warranted when there is a documented change in the patient's functional status, necessitating an updated assessment and plan of care.

2. Procedure

The procedure for re-evaluation under CPT® Code 97172 involves several key steps that ensure a comprehensive assessment of the patient's current condition and the effectiveness of the existing treatment plan.

Assessment of Current Functional Status The first step in the re-evaluation process is to conduct a thorough assessment of the patient's current functional status. This involves gathering an interim history that includes any changes in symptoms, response to previous treatments, and overall physical performance. The clinician evaluates various physical parameters, such as range of motion, strength, flexibility, agility, speed, endurance, and power, to determine how the patient's condition has progressed or regressed since the last evaluation.
Revised Plan of Care Following the assessment, the clinician develops a revised plan of care. This plan is based on the findings from the assessment and may include updates to management options, goals, and interventions. The clinician utilizes standardized patient assessment instruments and measurable assessments of functional outcomes to ensure that the revised plan is tailored to the patient's current needs and circumstances. This step is crucial for optimizing the patient's rehabilitation and preventing recurrent athletic injuries.

3. Post-Procedure

After the re-evaluation procedure is completed, the patient may receive updated recommendations for their rehabilitation and training program. The clinician will discuss the revised plan of care with the patient and/or their family, ensuring that they understand the changes and the rationale behind them. Follow-up appointments may be scheduled to monitor the patient's progress and make further adjustments as necessary. The expected recovery and outcomes will depend on the individual patient's condition and adherence to the updated plan of care.

Short Descr	ATHLETIC TRN RE-EVAL PLAN CR
Medium Descr	ATHLETIC TRAINING RE-EVAL EST PLAN CARE 20 MINS
Long Descr	Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient's current functional status when there is a documented change; and A revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome with an update in management options, goals, and interventions. Typically, 20 minutes are spent face-to-face with the patient and/or family.
Status Code	Non-Covered Service
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Non-Covered Service, not paid under OPPS
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	M5D - Specialist - other
MUE	0

GP	Services delivered under an outpatient physical therapy plan of care

90281-99607 Medicine Services and Procedures

97161-97799 Physical Medicine and Rehabilitation Procedures

97169-97172 Athletic Training Evaluations

97169 ATHLETIC TRAINING EVAL LOW COMPLEX 15 MINS

97170 ATHLETIC TRAINING EVAL MOD COMPLEX 30 MINS

97171 ATHLETIC TRAINING EVAL HIGH COMPLEX 45 MINS

97172 ATHLETIC TRAINING RE-EVAL EST PLAN CARE 20 MINS

Date	Action	Notes
2017-01-01	Added	Added

Code	Description

No matching codes found

Code	Description

No matching codes found

Official Description

Common Language Description

1. Indications

2. Procedure

3. Post-Procedure

Code Data Insights

Modifier Assist

Chapter & Section Hierarchy

Code History

ICD-10-CM Crosswalk

ICD-10-PCS Crosswalk