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Official Description

Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Work hardening/conditioning is a therapeutic approach utilized primarily after a work-related injury to facilitate an individual's return to their job while preventing future injuries. 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 program is designed to track progress and improvements, with the ultimate goal of enabling the individual to return to work safely and effectively. It is important to note that work conditioning and work hardening, while related, serve different purposes. Work conditioning emphasizes exercises aimed at enhancing the body's strength and conditioning to restore neuromuscular and musculoskeletal functions, which include strength, endurance, mobility, and flexibility. This may involve various activities such as cardiovascular training on a treadmill or stationary bicycle, weight training, circuit training, and educational components. Conversely, work hardening is a more intensive form of therapy that concentrates 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 productively and safely. 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 itself. For billing purposes, CPT® Code 97545 is designated for the initial two hours of therapy, while CPT® Code 97546 is applied for each additional hour of service provided.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of work hardening/conditioning is indicated for individuals recovering from work-related injuries. The following conditions may warrant the implementation of this therapeutic approach:

  • Work-Related Injuries Individuals who have sustained injuries in the workplace that affect their ability to perform job-related tasks.
  • Functional Limitations Patients exhibiting limitations in physical capabilities that hinder their return to work.
  • Need for Rehabilitation Those requiring structured rehabilitation to regain strength, endurance, and functional mobility.
  • Prevention of Future Injuries Individuals who need to develop skills and conditioning to prevent re-injury upon returning to their job.

2. Procedure

The work hardening/conditioning procedure involves several key steps that are essential for effective rehabilitation. Each step is designed to ensure that the individual is adequately prepared to return to work safely and productively.

  • Initial Assessment The process begins with a thorough baseline assessment conducted by a qualified therapist. This assessment evaluates the individual's current functional abilities, including strength, endurance, mobility, and flexibility. The therapist gathers information on the patient's medical history, specific injuries, and any limitations that may affect their work performance.
  • Program Development Based on the initial assessment, the therapist develops a customized therapy program tailored to the individual's needs. This program outlines specific goals and objectives, focusing on restoring the necessary physical capabilities required for the individual's job functions.
  • Implementation of Therapy The therapy program is implemented, which may include a combination of work conditioning and work hardening activities. Work conditioning focuses on exercises that enhance overall physical fitness, while work hardening involves real or simulated tasks that mimic job requirements. The therapist supervises the individual during these activities to ensure proper technique and safety.
  • Progress Monitoring Throughout the therapy sessions, the therapist continuously monitors the individual's progress. This includes assessing improvements in strength, endurance, and functional abilities, as well as observing the individual's tolerance for various activities. Adjustments to the therapy program may be made based on the individual's progress and feedback.
  • Final Evaluation Upon completion of the therapy program, a final evaluation is conducted to determine the individual's readiness to return to work. The therapist assesses whether the individual has met the established goals and can perform job-related tasks safely and effectively.

3. Post-Procedure

After the completion of the work hardening/conditioning program, individuals may require ongoing support to ensure a successful transition back to work. Post-procedure care may include follow-up appointments with the therapist to monitor continued progress and address any emerging issues. Additionally, individuals may benefit from education on injury prevention strategies and ergonomic practices to maintain their health and safety in the workplace. It is essential for individuals to communicate any concerns or difficulties they encounter as they return to their job, allowing for timely interventions if necessary.

Short Descr WORK HARDENING ADD-ON
Medium Descr WORK HARDENING/CONDITIONING EACH HOUR
Long Descr Work hardening/conditioning; each additional hour (List separately in addition to code for primary procedure)
Status Code Restricted Coverage
Global Days ZZZ - Code Related to Another Service
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 2
CCS Clinical Classification 213 - Physical therapy exercises, manipulation, and other procedures

This is an add-on code that must be used in conjunction with one of these primary codes.

97545 MPFS Status: Restricted APC A PUB 100 CPT Assistant Article Work hardening/conditioning; initial 2 hours
GP Services delivered under an outpatient physical therapy plan of care
Date
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1993-01-01 Added First appearance in code book in 1993.
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