Pediatric Billing Coding: Review & Reframe CPT Codes… All Children… All Settings…

January 1st, 2017 The Center for Medicare and Medicaid Services rolled out new Physical Therapy Evaluation and Reevaluation Codes and on January 1st, 2024 (CMMS) also rolled out new codes related to Caregiver Training. Clinicians have expressed ongoing challenges with the coding rules for evaluation and reevaluation for physical therapy as it relates to pediatrics. There are variances in how clinicians apply codes in general to specific treatment interventions and patient/caregiver education. This course will guide clinicians through the process of selecting the most appropriate code using a combination of CMS guidelines, APTA guidelines, the International Classification of Function (ICF) and clinical decision making. Participants will utilize cased based review to demonstrate simple, evolving and complex pediatric evaluation cases in multiple treatment settings. Documentation systems will be reviewed to ensure documentation is defensible and inclusive of the clinical decision making to support the evaluation code selected. Discussion will occur around complexity of clinical assessment and the how to make decisions when a clinical case is between two levels.