Therapy Type Definitions
When building the platform, we wanted to provide our clients with the ability to filter their data by type of therapy since there are important nuances with each type. For example, we know the billing for a splinting visit is expected to be much different compared to a normal PT or OT visit.
Additionally, compliance rules are slightly different for certain therapy types. Since we are able to filter by Therapy Type, we can exclude certain types from the Compliance section of Prompt Insight. These include Long Term Pediatric, Work Hardening or Work Conditioning and FCE visits.
| Therapy Type | Rule |
| Splint Visit | CPT codes: L-codes (start with “L”) |
| Strapping / Casting Visit | CPT codes: 29-codes (start with “29”) |
| Work Hardening or Work Conditioning Visit | CPT codes: 97545 or 97546 |
| FCE Visit | CPT code: 97750 |
| Long Term Pediatric | Age at first visit: below 18 ICD-10 Categories: A50, A51, E00, E45, F, G11, G40, G80-83, G91, K00, M08, M20-21, M41, M42.0, M43.6, M62.81, M67, M89.2, M91, M92, M95, P, Q, R13, R26, R27, R41, R44-49, R53, R56, R62, R63, T74, T76, T79, Z13.4, Z32 |
| Neuro | ICD-10 Categories: A69.22, B02.29, C47, C71, C72, C7a, C7B, D33, D3A, D36.1, D43, D49.6, E11.4, F44, F84, F88, G09, G10-14, G20, G30-37, G40, G56-59, G60-65, G80-83, G9, H81, I63, M41.4, P11, P14, Q0-7, Q85, R29, R41, R56, R90, S06, T44, Y75, Z87.82 |
| Arm Visit | ICD-10 Categories: M79.63, S50-59, G56.1-56.4, G56.8-56.9, M77.0-77.2, M79.601-79.603, M79.62, S40-49 |
| Hand Visit | ICD-10 Categories: M79.64, S60-69, G56.0, M65.4, M65.3, M65.84, M65.24, M65.14, M65.04, M18 |
| Speech Therapy | ICD-10 Categories: F80, F84.2, F95, I69.02-69.92, R13, R41, R47-49 |
If you need any assistance please reach out to support.insight@prompthealth.com