Coding Clarification: Codes 97542 and 97755 (March 2021)

March 2021 page 4 Coding Clarification: Codes 97542 and 97755 Significant technological advancements have resulted in increased access to mobility devices that help patients optimize function and maximize environmental access. Due to this emerging technology, there has been confusion about how to correctly report Current Procedural Terminology (CPT®) codes 97542 (wheelchair management) and 97755 (assistive technology assessment). This article clarifies the intent and appropriate use of these two codes. Therapeutic Procedures  97542Wheelchair management (eg, assessment, fitting, training), each 15 minutes Tests and Measurements  97755Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This March 2021 CPT® Assistant article explains the general intent and appropriate reporting context for two therapy-related services in the Medicine section of CPT®. It is aimed at coders, therapists, and other billing or documentation staff who need a better understanding of when these services are discussed and what broad documentation themes are involved. The article also touches on related training services and the broader clinical settings in which assistive technology and wheelchair-related care may arise.

Why This Topic Matters

Accurate reporting of therapy and assistive-technology services depends on understanding the scope of each service and how it is positioned within CPT®. This article helps readers distinguish the broad categories of assessment, management, and training discussed in the March 2021 guidance.

Article Sections

  1. Overview of Code 97755

    Describes the general focus of an assistive technology assessment service within CPT® 2021 and discusses the broader clinical contexts in which such assessments may occur.

  2. Coding Tip

    Provides related guidance on adjacent training services and how they are discussed in connection with assistive technology use.

  3. Overview of Code 97542

    Summarizes the wheelchair management service and the broad categories of patient management activities associated with it.

What You Will Learn

  • How the article frames two CPT® therapy-related services in a 2021 context.
  • What broad subjects are associated with assistive technology assessment.
  • What general topics are associated with wheelchair management and related training.
  • How the article connects assistive technology discussion with nearby therapy services.

Who Should Read This

  • Medical coders
  • Billing specialists
  • Therapists
  • Clinical documentation staff
  • Physician and QHP practices

Codes Discussed

  • CPT: 97542
  • CPT: 97755
  • CPT: 97535
  • CPT: 97537

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