Is 97112, Neuromuscular Re-education Only for Stroke Recovery?

by  ChiroCode™
Jun 1st, 2017 - Reviewed/Updated Jan 31st

This code is not reserved for stroke recovery, but it could certainly apply when treating some symptoms of a stroke. It is often used for many other conditions so long as medical necessity is present and clearly supported.

Consider using this on patients with documented loss of coordination or balance. These might not be everyday cases in a chiropractic clinic, but they certainly would occur from time to time.

The service should focus on restoring the specific functional loss. If the purpose is to improve strength, range of motion, or flexibility, then consider 97110 therapeutic exercises instead.

Here is some additional info:

97112 - Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities Therapeutic procedures for neuromuscular reeducation are used to develop conscious control of a single muscle or muscle group and heighten the awareness of the body's position in space, especially the position of the extremities when sitting or standing.

Neuromuscular reeducation is employed during the recovery or regeneration stage following severe injury or trauma, cerebral vascular accident, or systemic neurological disease. The goal of therapy is improved range of motion (ROM), balance, coordination, posture, and spatial awareness.

Techniques may include proprioceptive neuromuscular facilitation which uses diagonal contract-relax patterns of skeletal muscles to stimulate receptors in the joints that communicate body position to the brain via motor and sensory nerves.

Feldenkrais is a method which observes the patient's habitual movement patterns and teaches new patterns based on efficient active or passive repetitive conditioning. Additional techniques that may be useful for neuromuscular reeducation are Bobath concept, which promotes motor learning and efficient motor control, and biomechanical ankle platform system (BAPS) boards.