Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Rehabilitative Services)
Occupational Therapy
(continued)
Occupational Therapy
Evaluation Codes
11-4
Code Category Units of Service
97750-97755 Test and measurements 1 unit for each 15
minutes
97760-97762 Orthotic and Prosthetic
management
1 unit for each 15
minutes
97799 Other procedures 1 unit (designate time)
29105-29131
and 29505-
29515
Splints 1 unit
29240-29280 Strapping 1 unit
92526,
92610-92617
95831-95852
and 95999
Special
otorhinolaryngologic
services
Neurology and
neuromuscular
procedures
1 unit
1 unit
96105 Aphasia assessments 1 unit per hour
96110-96111 Developmental testing 1 unit
Occupational therapists should submit evaluation and re-evaluation
services using the CPT codes 97003 and 97004.
Code Category Units of Service
97003-97004 Evaluation and reevaluation
1 unit
These codes may be reported separately if the patient’s condition
requires significant separately identifiable services, above and
beyond the usual pre-service and post-service work associated with
the procedure performed.
The modifier -25 (significant, separately identifiable evaluation
and management service by the same physician on the same day as
the procedure or other service) is not valid with the occupational
therapy (OT) evaluations and re-evaluation codes 97003-97004.
The evaluation or re-evaluation codes will be allowed, as
appropriate, when billed with other physical or occupational
services on the same date. Because the modifier -25 is not valid
with 97003-97004, if submitted, the service will be denied.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (03/19/12)