Using Therapeutic Exercise and Activity Codes in Practice, and How GripAble Can Help
In the day-to-day practice of PT’s and OT’s, Therapeutic Activities (97530) and Therapeutic Exercises (97110) are two of the most used codes, but these can also be the most confusing. However, while similar in name, the two codes differ in use as well as potential reimbursement amount. In order to maximize clinical benefit and reimbursement potential, therapists should be clear on when to use either, and how to best document their usage.
In this blog post, we will explore these topics, and lay out why GripAble is your secret weapon for billing for Therapeutic Activities.
Understanding the Two Codes
To properly differentiate the two, it helps to think of therapeutic exercises as a path, or building block to therapeutic activities.
Therapeutic Exercise (TherEx – CPT Code 97110):
Therapeutic exercise involves looking at only one parameter being measured. This is typically performed to prevent loss in range of motion, and to maintain or improve muscular strength. These exercises can also increase flexibility after an injury or surgery.
• Active, active-assisted, or passive range of motion for increased range of motion of a specific joint.
• Resistance exercises for improved muscular strength, including isometric, isotonic, and isokinetic.
• Exercises to improve aerobic or cardiopulmonary endurance.
• Any active stretches, which assist in improving range of motion and flexibility.
Since these are all separate activities, they are separately billed under therapeutic exercise code (97110).
To ensure defensible documentation for therapeutic exercise code 97110 make sure you include – The body part(s) treated, and specific muscle(s) and/or joint(s) to avoid any confusion about each exercise.
Case example: Mr X recovering from a work injury to his wrist might begin physical therapy with therapeutic exercise in the form of wrist ROM exercises. These exercises are limited to a single parameter (active ROM) making it a therapeutic exercise.
Therapeutic Activity (TherAct – CPT Code 97530):
Therapeutic activities are movements or actions that simulate real-life situations, or recreation. They are intended to help patients regain functional skills that may have been lost due to physical impairments or disabilities. Therapeutic activities focus on improving a patient’s balance, coordination, endurance, and mobility, and usually looks at multiple parameters (e.g.combination of range of motion and strength, or range of motion and endurance).
Here are some helpful questions to ask yourself when considering therapeutic activity:
• Is this a functional activity – such as catching a ball or climbing the stairs?
• Will this improve his/her functional performance in daily activities?
• Is there more than one parameter (ROM, strength, coordination, etc.) being addressed with this activity?
Does this activity directly correspond or relate to a specific work or sports task that the patient will be performing once they have fully recovered?
If you answered yes to the questions above, you can bill for therapeutic activity 97530. In order to ensure your documentation is defensible, document the specific relationship to a functional activity and how it applies to that particular patient.
Case example: Mr X’s range of motion improves and a weight is added requiring wrist stabilization against gravity and hand and wrist range of motion. This will enable Mr X to carry a cup of coffee without pain or discomfort. Now the movement is a therapeutic activity (97530), as a second parameter (strength) has been added.
Comparing the Codes
Both therapeutic exercises and activities have significant benefits for patients. Therapeutic exercises help improve muscle strength, flexibility, and endurance, thereby reducing pain, inflammation, and fatigue. They can help prevent further injury and facilitate better functional performance. Therapeutic activities specifically can enhance social interaction, emotional wellbeing, and quality of life in patients. They provide a sense of achievement, self-esteem, and independence that patients may have lost due to their condition.
While both codes offer significant benefit to the patient, it is extremely important that therapists accurately identify and bill the correct code. The therapeutic activity code has the potential to be reimbursed at a much higher rate than therapeutic exercise- with an average difference in reimbursement of $9/15 min. Failing to use the codes correctly could result in achieving a lower reimbursement rate than you could.
GripAble & Therapeutic Coding
GripAble & Therapeutic Exercise (CPT Code 97110):
GripAble can be used to enhance therapeutic exercises by immersing patients in interactive, gamified hand and wrist exercises that can be used to address range of motion and strength.
The tracking feature enables therapists to accurately monitor movements, repetitions and minutes played. The digital documentation in GripAble provides therapists with real-time data on patients’ performance, and allows for adjustments in the exercise program as needed. This data-driven approach ensures that exercises are tailored to each patient’s specific needs, enhancing effectiveness.
GripAble & Therapeutic Activity (CPT Code 97530):
GripAble offers a wide selection of interactive activities that simulate real-life situations that simultaneously target multiple parameters crucial for hand and arm function. These activities include grip strength, coordination, range of motion, and fine motor skills.
For instance, during the game “Space Shooter,” patients engage in pronation/supination movements along with grip and release actions. This multi-parameter engagement aligns perfectly with the criteria for CPT code 97530, which focuses on functional activities addressing various aspects of rehabilitation.
GripAble can bridge the gap between patients’ functional goals and clinical goals. Therapists can customize activities to simulate real-life tasks like pouring water, brushing teeth, or using a walker. By incorporating these daily activities into therapy, GripAble can be used to improve patients’ functional abilities and independence, making it a strong candidate for billing under CPT code 97530.
GripAble: Billing and Documentation
GripAble is a versatile tool that enhances both therapeutic exercises (CPT code 97110) and therapeutic activities (CPT code 97530) in hand and wrist rehabilitation. Its interactive platform engages patients, facilitates precise documentation, and supports therapists in providing effective, billable care. GripAble is a valuable asset for therapists seeking to optimize clinical outcomes and maximize reimbursement potential in their practice.