Code: 97760
Description: Orthotic management and training (including assessment and fitting when not otherwise reported), initial encounter, each 15 minutes
Context: This code is used for the initial encounter in orthotic management and training. It includes services such as assessing the patient’s needs, fitting the orthotic device, and training the patient in its use. The code is time-based and is billed in 15-minute increments.
Guidelines for Proper Use
- Specific Use for Orthotic Management and Training: Apply 97760 for initial encounters involving orthotic management, which can include assessing the patient’s needs, fitting the orthotic device, and training in its use.
- Documentation of Time and Services: Ensure healthcare providers’ documentation includes the length of time spent in the management and training session and details of the services provided.
- Initial Encounter Emphasis: This code is used for the initial encounter. Subsequent encounters or follow-up visits may require different coding.
- Time-Based Billing: 97760 is billed based on the time spent with the patient, in 15-minute increments. Accurate recording of time is essential.
- Compliance with Orthotic Management Protocols: Use 97760 in accordance with standard orthotic management guidelines and protocols, as well as payer-specific rules.
Common Misuses of 97760
- Using for Subsequent Encounters: Misuse occurs if 97760 is applied to follow-up or subsequent training sessions after the initial encounter.
- Inaccurate Time Reporting: Billing for time not actually spent in orthotic management and training, or rounding up time improperly, is a misuse.
- Omission of Detailed Service Description: Not providing detailed descriptions of the management and training services rendered can lead to misuse of this code.