{"id":2208,"date":"2024-12-03T10:54:35","date_gmt":"2024-12-03T10:54:35","guid":{"rendered":"https:\/\/medibillmd.com\/blog\/?p=2208"},"modified":"2025-02-28T12:55:29","modified_gmt":"2025-02-28T12:55:29","slug":"cpt-code-97760","status":"publish","type":"post","link":"https:\/\/medibillmd.com\/blog\/cpt-code-97760\/","title":{"rendered":"Ultimate Guide to CPT Code 97760"},"content":{"rendered":"\n<p>How often have you come across CPT code descriptions that have left you in utter confusion? Selecting the most appropriate CPT code from a vast code set is challenging, especially when minor and often unnoticeable differences make them distinct from one another. The situation with Orthotic Management and Training and Prosthetic Training codes 97760, 97761, and 97763 is quite similar.&nbsp;<\/p>\n\n\n\n<p>To make the distinction clear, we will dissect CPT code 97760 in this ultimate guide and tell you how codes 97760 and 97763 compare and contrast. Moreover, we will look at the real-world applications of the 97760 CPT code and its billing best practices to enhance your coding accuracy. So, read on to know the details.&nbsp;<\/p>\n\n\n\t\t\t\t<div class=\"wp-block-uagb-table-of-contents uagb-toc__align-left uagb-toc__columns-1 uagb-toc__collapse uagb-block-87a3b87f      \"\n\t\t\t\t\tdata-scroll= \"1\"\n\t\t\t\t\tdata-offset= \"30\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t\t>\n\t\t\t\t<div class=\"uagb-toc__wrap\">\n\t\t\t\t\t\t<div class=\"uagb-toc__title\">\n\t\t\t\t\t\t\tTable Of Contents\t\t\t\t\t\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 384 512\"><path d=\"M192 384c-8.188 0-16.38-3.125-22.62-9.375l-160-160c-12.5-12.5-12.5-32.75 0-45.25s32.75-12.5 45.25 0L192 306.8l137.4-137.4c12.5-12.5 32.75-12.5 45.25 0s12.5 32.75 0 45.25l-160 160C208.4 380.9 200.2 384 192 384z\"><\/path><\/svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uagb-toc__list-wrap \">\n\t\t\t\t\t\t<ol class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#97760-cpt-code-description\" class=\"uagb-toc-link__trigger\">97760 CPT Code &#8211; Description<\/a><li class=\"uagb-toc__list\"><a href=\"#scenarios-where-cpt-code-97760-is-applicable\" class=\"uagb-toc-link__trigger\">Scenarios Where CPT Code 97760 is Applicable<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#fitting-of-an-ankle-foot-orthosis-for-lower-extremity-deformity\" class=\"uagb-toc-link__trigger\">Fitting of an Ankle-Foot Orthosis for Lower Extremity Deformity<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#training-management-of-spinal-orthotics-for-back-pain\" class=\"uagb-toc-link__trigger\">Training &amp; Management of Spinal Orthotics for Back Pain\u00a0\u00a0<\/a><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#cpt-code-97760-vs-97763-key-differences\" class=\"uagb-toc-link__trigger\">CPT Code 97760 vs. 97763 &#8211; Key Differences<\/a><li class=\"uagb-toc__list\"><a href=\"#97760-cpt-code-reimbursement-guidelines\" class=\"uagb-toc-link__trigger\">97760 CPT Code &#8211; Reimbursement Guidelines<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#conduct-a-comprehensive-initial-assessment\" class=\"uagb-toc-link__trigger\">Conduct a Comprehensive Initial Assessment\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#document-and-provide-proof-of-medical-necessity\" class=\"uagb-toc-link__trigger\">Document and Provide Proof of Medical Necessity\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#note-the-time-for-provider-patient-encounter\" class=\"uagb-toc-link__trigger\">Note the Time for Provider-Patient Encounter<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#record-the-devices-functionality-treatment-plan-and-results\" class=\"uagb-toc-link__trigger\">Record the Device\u2019s Functionality, Treatment Plan, and Results<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#ensure-the-service-was-offered-in-an-outpatient-setting\" class=\"uagb-toc-link__trigger\">Ensure the Service was Offered in an Outpatient Setting<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#do-not-report-cpt-code-97760-with-97116-for-the-same-extremity\" class=\"uagb-toc-link__trigger\">Do Not Report CPT Code 97760 with 97116 for the Same Extremity<\/a><\/li><\/ul><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#final-word\" class=\"uagb-toc-link__trigger\">Final Word\u00a0<\/a><\/ul><\/ul><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>97760 CPT Code &#8211; Description<\/strong><\/h2>\n\n\n\n<p>The Current Procedural Terminology (CPT) code 97760 is an orthotic management code. It is commonly reported by occupational therapists to seek reimbursement for an initial 15-minute training session on the correct use of an orthotic device attached to the body\u2019s upper or lower extremity or trunk area.&nbsp;<\/p>\n\n\n\n<p>The provider fits the device on the patient and adjusts it if needed to enhance its functionality. Moreover, the timed encounter involves developing a treatment plan, training the patient on how to wear the device, skin checks, and assessing the patient\u2019s comfort level.&nbsp;<\/p>\n\n\n\n<p>Medicare Part B covers the CPT code 97760, given that the assessment, fitting, and training of the orthotic device was medically necessary. Moreover, the provider should be registered with Medicare, and the service must be performed in an outpatient setting. The Medicare reimbursement rate for the 97760 CPT code in the current fiscal year is between $41 and $61, depending on the MAC locality and outpatient facility.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Scenarios Where <\/strong><strong>CPT Code 97760<\/strong><strong> is Applicable<\/strong><\/h2>\n\n\n\n<p>Let\u2019s look at some real-world scenarios where CPT code 97760 can be used most appropriately for efficient billing and seamless payment collection.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Fitting of an Ankle-Foot Orthosis for Lower Extremity Deformity<\/strong><\/h3>\n\n\n\n<p>Ankle-foot orthoses (AFOs) are specialized external biomechanical devices that are worn below the knee to stabilize the joints and treat muscle weakness. These braces offer support and functionality to patients with deformed limbs, stroke, and other neurological conditions like cerebral palsy. Several types and designs are available for this orthotic, and each one is custom-made to ensure an intimate fit.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Scenario<\/strong><\/h4>\n\n\n\n<p>A man with diabetic peripheral neuropathy visits the physical therapist\u2019s office after being prescribed an ankle-foot orthosis to manage nerve damage and prevent further foot deformity like Charcot Foot. The therapist directly meets the patient, assesses the fabricated device, fits it on the patient, and asks the patient about his comfort level. If the device requires modification, the therapist will make a note of it. The patient is asked to stand and walk in it for training purposes, after which the therapist will create a management plan and instruct the patient on its correct use. For example, how long should the device be worn, how should it be taken care of, and what to do in case of pain or skin infections?&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Take Away&nbsp;&nbsp;<\/strong><\/h4>\n\n\n\n<p>Report CPT code 97760 if the orthotics management session lasted 15 minutes in an outpatient setting and was the first of its kind for the patient.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Training &amp; Management of Spinal Orthotics for Back Pain&nbsp;&nbsp;<\/strong><\/h3>\n\n\n\n<p>In this case, the focus area is the body\u2019s trunk. Spinal orthotics (like back supports and braces) treat back pain, fractures, and poor posture by correcting the curvature of the spine and realigning the vertebrae. A therapist at an outpatient facility will report CPT code 97760 when he assesses, fits, and reviews the spinal orthotic on a patient suffering from back pain, trauma, or deformity.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Scenario<\/strong><\/h4>\n\n\n\n<p>An elderly patient with a hunched back meets a physical therapist for the fitting and management of a lower back brace to alleviate pain and control curving. The therapist meets the patient in an assisted living facility for 15 minutes to try on the brace, adjust its fit (if needed), and guide the patient on the orthotic\u2019s daily use.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Take Away<\/strong><\/h4>\n\n\n\n<p>Report the 97760 CPT code for every 1 unit of initial direct contact with the patient for the training and management of a spinal orthotic in an outpatient setting. Maintain adequate documentation to prove its medical necessity, e.g., severe lower back pain.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>CPT Code 97760 <\/strong><strong>vs. 97763 &#8211; Key Differences<\/strong><\/h2>\n\n\n\n<p>CPT codes 97760, 97761, and 97763 are all part of the \u2018Orthotic Management and Training and Prosthetic Training\u2019 code range as maintained by the American Medical Association. However, each of these denotes a specific service delivered by the occupational therapist.&nbsp;<\/p>\n\n\n\n<p>For example, while CPT codes 97760 and 97761 exclusively cover the initial assessment, fitting, training and management of just one type of device, CPT code 97763 reports the subsequent encounter for the training and management of both orthotic and prosthetic device(s).&nbsp;<\/p>\n\n\n\n<p>You must also note that in 2018, CPT code 97762 was deleted and replaced with code 97763 to offer a better degree of specificity. Below, we have compared CPT codes 97760 and 97763 to highlight their similarities and differences.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\"><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>CPT Code 97760<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>CPT Code 97763<\/strong><\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Medical Specialty&nbsp;<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Occupational Therapy, Physical Therapy, Chiropractic&nbsp;&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">Occupational Therapy, Physical Therapy, Chiropractic&nbsp;&nbsp;<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Time Duration&nbsp;<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">15 minutes&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">15 minutes<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Parties Involved&nbsp;<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Provider and patient&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">Provider and patient<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Purpose of the Service&nbsp;<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Assessment, training, and management of an orthotic device&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">Training and management of an orthotic\/prosthetic device&nbsp;<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Degree of Encounter<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">Initial&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">Subsequent<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\"><strong>Medicare Reimbursement Rate<\/strong><\/td><td class=\"has-text-align-center\" data-align=\"center\">$41.50 &#8211; $60.21<\/td><td class=\"has-text-align-center\" data-align=\"center\">$44.99 &#8211; $66.46<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>From the table above, we can see that the primary differences between CPT codes 97760 and 97763 are the order of the encounter, what is involved in each visit, and the Medicare reimbursement rates.&nbsp;<\/p>\n\n\n\n<p>CPT code 97760 is an initial encounter involving the first assessment and fitting of the orthotic device. During this visit, the patient receives initial training on how to wear and use the device. Hence, the Medicare reimbursement rate for the 97760 CPT code is typically lower.&nbsp;<\/p>\n\n\n\n<p>In contrast, CPT code 97763 reports follow-up visits to learn the appropriate use of the device, especially due to skin irritation, trips and falls, and pain. Therefore, Medicare pays a slightly higher rate for this subsequent visit.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>97760 CPT Code &#8211; Reimbursement<\/strong><strong> Guidelines<\/strong><\/h2>\n\n\n\n<p>Failure to follow standardized guidelines and payer-specific coding policies can result in claim denials and loss of revenue. You need a steady flow of reimbursements to keep your practice sustainable amidst the growing competition in the healthcare landscape. So, how can you prevent errors and oversights when coding and billing CPT code 97760 to ensure accurate and timely payment collection?&nbsp;<\/p>\n\n\n\n<p>The answer is down below. We have compiled some CMS-approved tips that will help you code and bill 97760 better, paving the way for maximized reimbursements. Take a look!&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Conduct a Comprehensive Initial Assessment&nbsp;<\/strong><\/h3>\n\n\n\n<p>The term \u2018assessment\u2019 in the description for CPT code 97760 extends to patient assessment as well. As a provider, you must assess the patient\u2019s condition before fitting an orthotic device. For example, you must consider the patient\u2019s functional limitations, complications, impairments, and comfort level with the device before instructing him to wear one. You must also record the findings and submit them later as supporting documentation.&nbsp;<\/p>\n\n\n\n<p>To assess the device, you are required to report its HCPCS \u2018L\u2019 code and check whether the device is the right size, fit, make, and model. If the device was modified (custom-built for the patient), you must make a note of it in your physical therapy notes and use the correct \u2018L\u2019 code to denote the time it took to cast the orthotic.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Document and Provide Proof of Medical Necessity&nbsp;<\/strong><\/h3>\n\n\n\n<p>The next step is to ensure that you maintain and submit complete and correct documentation to prove the medical necessity of a training and management session on an orthotic device denoted by CPT code 97760.&nbsp;<\/p>\n\n\n\n<p>For example, you must include the patient\u2019s complete medical history, X-ray reports, clinical notes highlighting deformed limbs, damaged muscles, etc. You must also explain why a skilled therapist\u2019s assistance was needed to fit the device and train the patient, e.g., the patient was elderly or using the equipment for the first time, etc. Please note that any orthotic device or service that is not medically necessary, such as the custom-fitted pressure garments, will not be reimbursed as the patient can easily do without it.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Note the Time for Provider-Patient Encounter<\/strong><\/h3>\n\n\n\n<p>The 97760 CPT code is time-based. It reports the first 15 minutes of a provider-patient encounter during which the orthotic is assessed and fitted on the patient. You must be mindful of the time you spend in direct contact with the patient to report 1 unit of training component (15 minutes) for CPT code 97760.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Plus, you must take down the total duration of the session to accurately bill for other occupational therapy services like CPT code 97165 for OT evaluation. It will help you collect rightful reimbursements for the time you spend with the patient, whether evaluating the patient\u2019s condition for 30 minutes or offering training for another 20 minutes.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Record the Device\u2019s Functionality, Treatment Plan, and Results<\/strong><\/h3>\n\n\n\n<p>Your detailed documentation must include the device\u2019s functionality and performance metrics. For example, you must take the measurement of the orthotic device and record how functional it was at the time of the fitting, e.g., its elasticity and grip.&nbsp;<\/p>\n\n\n\n<p>Next, you must document the treatment plan you had created for the patient, e.g., how many times a day they should wear it or how long they should walk in it. The last thing you must record for the accurate reporting of CPT code 97760 is the initial results of using the orthotic device. These will become visible as the patient tries on the device and trains in it for the first 15 minutes.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Ensure the Service was Offered in an Outpatient Setting<\/strong><\/h3>\n\n\n\n<p>CPT code 97760 indicates an outpatient physical or occupational therapy service. Hence, the code cannot be used if the training and management were performed in an inpatient setting. You can report the 97760 CPT code if a qualified and registered healthcare professional provides the orthosis and instructions on using it in the patient\u2019s home, an outpatient center, or a skilled nursing facility (SNF).&nbsp;&nbsp;<\/p>\n\n\n\n<p>According to the <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=56566\" rel=\"nofollow noopener\" target=\"_blank\">Centers for Medicare and Medicaid Services<\/a> (CMS), the 97760 CPT code is billable by:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Outpatient rehabilitation facilities,<\/li>\n\n\n\n<li>Outpatient hospital therapy departments\u00a0<\/li>\n\n\n\n<li>Comprehensive outpatient rehabilitation facilities (CORFs)<\/li>\n\n\n\n<li>Nursing homes (patients covered under Medicare Part B stay)<\/li>\n\n\n\n<li>Home health agencies (patients not under an HH care plan)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Do Not Report <\/strong><strong>CPT Code 97760<\/strong><strong> with 97116 for the Same Extremity<\/strong><\/h3>\n\n\n\n<p>Medicare does not permit the use of CPT code 97116 with 97760 if you are placing the device on the same extremity (upper or lower). Physical and rehabilitation therapists use code 97116 to denote 15 minutes of gait training, like climbing stairs or walking comfortably without strain. Hence, the two services are separately billable and should not be reported together even if the focus area (upper\/lower extremity or trunk) is the same.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Final Word&nbsp;<\/strong><\/h2>\n\n\n\n<p>97760 is one of the most used CPT codes in occupational therapy. Physical, occupational, pediatric, and rehabilitation therapists report CPT code 97760 when they provide orthotics management and training in an outpatient setting for the first 15 minutes. This code is applicable when the provider tests the orthotic and fits it on the patient for the first time. The 97760 CPT code also includes device modification, training the patient on it, and offering instructions for its management.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Claim submission for code 97760 involves comprehensive documentation to prove the medical necessity of the service. If this is something that you are struggling with, our professional <a href=\"https:\/\/medibillmd.com\/specialties\/physical-therapy-billing-services\"><strong>physical therapy billing services<\/strong><\/a> cover everything, from patient scheduling to medical coding and documentation to clean claim filing. Take the first step toward effortless billing!<\/p>\n\n\n\n<p class=\"has-text-align-center has-text-color has-link-color has-large-font-size wp-elements-abb47e80fabc22046fdcb7a89e86f1a7\" style=\"color:#045cb4;margin-bottom:var(--wp--preset--spacing--30)\"><strong>Frequently Asked Questions<\/strong><\/p>\n\n\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-6a7fb1d5 uagb-faq-icon-row-reverse uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\"><script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"@id\":\"https:\\\/\\\/medibillmd.com\\\/blog\\\/cpt-code-97760\\\/\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"<strong>Is CPT Code 97760 covered by Medicare?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare Part B covers occupational therapy. Since CPT code 97760 is an occupational therapy code for the training and management of orthotic devices, Medicare reimburses the encounter with up to $61 per visit. However, you must prove the medical necessity of the service through adequate documentation.\\u00a0\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can I bill 97760 with an L code?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You must use the appropriate HCPCS \\u2018L\\u2019 code with the 97760 CPT code to describe the orthotic device that was assessed and fitted on the patient. Moreover, the L code helps the payer understand whether the device was custom-made, fabricated in-house, molded to a patient\\u2019s body part, or did not require any fitting specifications.\\u00a0<br>Please note that the L code can only be used with the 97760 CPT code for the initial encounter in which the provider trains the patient on an orthotic device\\u2019s use.\\u00a0\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Does CPT code 97763 need a modifier?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. CPT code 97763 is an \\u2018<a href=\\\"https:\\\/\\\/www.cms.gov\\\/Regulations-and-Guidance\\\/Guidance\\\/Transmittals\\\/2017Downloads\\\/R3924CP.pdf\\\">always therapy<\\\/a>\\u2019 code used by speech, occupational, and physical therapists alike. Therefore, you must use the appropriate modifier - GN, GO, or GP - to indicate which plan of care you are referring to and billing in your claim. GN is for outpatient speech-language pathology, GO is for outpatient occupational therapy, and GP is for outpatient physical therapy.\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Is 97760 a timed code?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. CPT code 97760 is timed and reports an initial 15-minute-long encounter between the patient and the provider, during which the patient tries on an orthotic device, learns its use and receives instructions on managing it.\\u00a0\"}}]}<\/script><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-9d7f5ed0 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Is CPT Code 97760 covered by Medicare?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. Medicare Part B covers occupational therapy. Since CPT code 97760 is an occupational therapy code for the training and management of orthotic devices, Medicare reimburses the encounter with up to $61 per visit. However, you must prove the medical necessity of the service through adequate documentation.\u00a0\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c556ad62 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can I bill 97760 with an L code?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You must use the appropriate HCPCS \u2018L\u2019 code with the 97760 CPT code to describe the orthotic device that was assessed and fitted on the patient. Moreover, the L code helps the payer understand whether the device was custom-made, fabricated in-house, molded to a patient\u2019s body part, or did not require any fitting specifications.\u00a0<br>Please note that the L code can only be used with the 97760 CPT code for the initial encounter in which the provider trains the patient on an orthotic device\u2019s use.\u00a0\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c15eaf00 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Does CPT code 97763 need a modifier?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. CPT code 97763 is an \u2018<a href=\"https:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Transmittals\/2017Downloads\/R3924CP.pdf\" rel=\"nofollow noopener\" target=\"_blank\">always therapy<\/a>\u2019 code used by speech, occupational, and physical therapists alike. Therefore, you must use the appropriate modifier &#8211; GN, GO, or GP &#8211; to indicate which plan of care you are referring to and billing in your claim. GN is for outpatient speech-language pathology, GO is for outpatient occupational therapy, and GP is for outpatient physical therapy.\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-8f3da7cf \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Is 97760 a timed code?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. CPT code 97760 is timed and reports an initial 15-minute-long encounter between the patient and the provider, during which the patient tries on an orthotic device, learns its use and receives instructions on managing it.\u00a0<\/p><\/div><\/div><\/div>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>How often have you come across CPT code descriptions that have left you in utter confusion? Selecting the most appropriate [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":2209,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","content-type":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[10],"tags":[],"class_list":["post-2208","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cpt-codes"],"uagb_featured_image_src":{"full":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760.webp",1200,720,false],"thumbnail":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760-150x150.webp",150,150,true],"medium":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760-300x180.webp",300,180,true],"medium_large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760-768x461.webp",768,461,true],"large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760-1024x614.webp",1024,614,true],"1536x1536":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760.webp",1200,720,false],"2048x2048":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/Ultimate-Guide-to-CPT-Code-97760.webp",1200,720,false]},"uagb_author_info":{"display_name":"Fred Allen","author_link":"https:\/\/medibillmd.com\/blog\/author\/fred-allen\/"},"uagb_comment_info":0,"uagb_excerpt":"How often have you come across CPT code descriptions that have left you in utter confusion? Selecting the most appropriate [&hellip;]","_links":{"self":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/2208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/comments?post=2208"}],"version-history":[{"count":0,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/2208\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media\/2209"}],"wp:attachment":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media?parent=2208"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/categories?post=2208"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/tags?post=2208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}