How To Use CPT Code 97542

CPT 97542 describes the assessment, fitting, and training for wheelchair management by a healthcare provider, with each session lasting 15 minutes. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 97542?

CPT 97542 can be used to describe the assessment, fitting, and training services provided by a healthcare provider for wheelchair management. This code is used when the provider assesses the patient’s functional capabilities, determines the type and size of wheelchair required, and teaches the patient wheelchair maneuvering skills. Each session lasts for 15 minutes.

2. Official Description

The official description of CPT code 97542 is: ‘Wheelchair management (eg, assessment, fitting, training), each 15 minutes.’

3. Procedure

1. The healthcare provider assesses the patient’s functional capabilities to determine the type and size of wheelchair required.
2. Based on the assessment, the provider selects a wheelchair that provides stabilization, support, balance, and pressure management.
3. The provider schedules a 15-minute session with the patient to teach wheelchair maneuvering skills and provide instructions for adjustments and proper use of the wheelchair.
4. During the session, the provider focuses on promoting optimal safety, mobility, and transfers to and from the wheelchair.
5. The provider may also provide instructions on maintaining proper posture and pressure relief techniques.
6. Additional sessions may be scheduled as needed to ensure the patient becomes proficient in wheelchair management.

4. Qualifying circumstances

Patients eligible to receive CPT 97542 services are those who require wheelchair management, including assessment, fitting, and training. The provider must assess the patient’s functional capabilities and determine the type and size of wheelchair required. The goal is to select a wheelchair that provides stabilization, support, balance, and pressure management. The provider must also teach the patient wheelchair maneuvering skills, adjustments, and proper use of the wheelchair to promote safety, mobility, and transfers. Each session lasts for 15 minutes.

5. When to use CPT code 97542

CPT code 97542 should be used when a healthcare provider provides wheelchair management services, including assessment, fitting, and training, in 15-minute sessions. This code should be used for each 15-minute session provided to the patient. It is important to note that CPT code 97542 should not be reported with other codes for the same service.

6. Documentation requirements

To support a claim for CPT 97542, the healthcare provider must document the following information:

• Patient’s functional capabilities and the need for wheelchair management
• Type and size of wheelchair selected based on the assessment
• Date, start and end time of the 15-minute session
• Wheelchair maneuvering skills taught and instructions provided for adjustments and proper use
• Progress made by the patient and any additional sessions scheduled
• Signature of the healthcare provider providing the service

7. Billing guidelines

When billing for CPT 97542, ensure that the healthcare provider providing the service conducts the assessment, fitting, and training for wheelchair management. Each session should last for 15 minutes. It is important to note that CPT code 97542 should not be reported with other codes for the same service.

8. Historical information

CPT 97542, previously known as ‘Wheelchair management/propulsion training, each 15 minutes,’ was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates to the code since its addition.

9. Examples

1. A physical therapist assessing a patient’s functional capabilities and teaching wheelchair maneuvering skills during a 15-minute session.
2. An occupational therapist fitting a patient with the appropriate wheelchair and providing instructions for adjustments and proper use during a 15-minute session.
3. A rehabilitation specialist assessing a patient’s need for a wheelchair and teaching mobility and transfer techniques during a 15-minute session.
4. A healthcare provider teaching a patient pressure relief techniques and proper posture in a wheelchair during a 15-minute session.
5. A mobility specialist assessing a patient’s wheelchair needs and providing training on wheelchair maneuvering and adjustments during a 15-minute session.
6. A physical therapist teaching a patient how to safely transfer to and from a wheelchair and navigate different surfaces during a 15-minute session.
7. An occupational therapist assessing a patient’s wheelchair needs and providing training on wheelchair propulsion and maintenance during a 15-minute session.
8. A healthcare provider teaching a patient wheelchair maneuvering skills and proper use of assistive devices during a 15-minute session.
9. A rehabilitation specialist assessing a patient’s functional capabilities and providing training on wheelchair mobility and transfers during a 15-minute session.
10. A mobility specialist fitting a patient with a wheelchair and providing instructions for adjustments and proper use during a 15-minute session.

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