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Work hardening/conditioning is a specialized therapeutic approach utilized primarily after a work-related injury to facilitate the individual's return to their job. This process begins with a comprehensive baseline assessment conducted by a physical therapist or occupational therapist, who evaluates the individual's functional abilities. Following this assessment, a tailored therapy program is developed, focusing on the specific needs of the individual. The primary objective of work hardening/conditioning is to enhance the individual's capacity to perform work-related tasks while simultaneously preventing the risk of future injuries. It is important to note that work conditioning and work hardening, while related, serve distinct purposes. Work conditioning emphasizes exercises designed to strengthen and condition the body, aiming to restore neuromuscular and musculoskeletal functions such as strength, endurance, mobility, and flexibility. This may involve various activities, including cardiovascular training on equipment like treadmills or stationary bicycles, weight training, circuit training, and educational components. In contrast, work hardening is a more intensive form of therapy that focuses on real or simulated tasks that are essential for job performance. During this phase, the therapist closely monitors the individual's activity tolerance, body mechanics, lifting and carrying capacity, as well as their ability to sit, stand, walk, and climb. The program addresses not only physical aspects but also behavioral and vocational issues to ensure that the individual can work safely and productively. Typically, work hardening/conditioning programs are conducted for several hours a day, multiple times a week, either in a clinical therapy setting or within the workplace environment. The CPT® Code 97545 specifically refers to the initial two hours of this therapeutic intervention, while code 97546 is designated for each additional hour of service provided.
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The procedure of work hardening/conditioning is indicated for individuals recovering from work-related injuries. It is particularly beneficial for those who need to regain functional abilities necessary for their job roles. The following conditions may warrant the implementation of this therapy:
The work hardening/conditioning procedure involves several key steps that are essential for effective rehabilitation. Each step is designed to assess and improve the individual's functional abilities in a structured manner.
After the completion of the work hardening/conditioning sessions, the individual may require ongoing support and follow-up care. Post-procedure considerations include a review of the progress made during therapy and any remaining functional limitations. The therapist may provide recommendations for continued exercises or activities to maintain the gains achieved during the program. Additionally, the therapist may collaborate with the individual's employer to facilitate a smooth transition back to work, ensuring that any necessary accommodations are in place to support the individual's return to their job safely and effectively.
| Short Descr | WORK HARDENING | Medium Descr | WORK HARDENING/CONDITIONING 1ST 2 HR | Long Descr | Work hardening/conditioning; initial 2 hours | Status Code | Restricted Coverage | 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) | 0 - No payment adjustment rules for multiple procedures apply. | 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) | Z2 - Undefined codes | MUE | 1 | CCS Clinical Classification | 213 - Physical therapy exercises, manipulation, and other procedures |
This is a primary code that can be used with these additional add-on codes.
| 97546 | Addon Code MPFS Status: Restricted APC A PUB 100 CPT Assistant Article Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure) |
| 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. | GP | Services delivered under an outpatient physical therapy plan of care | 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. | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | KX | Requirements specified in the medical policy have been met |
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| 1993-01-01 | Added | First appearance in code book in 1993. |
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