Commonly Used Diagnostic Codes For SPD / SID Insurance Reimbursement
The first section of this information is available in the SENSORY INTEGRATION - SPECIAL INTEREST SECTION QUARTERLY Volume 22, number 1 March, 1999. Published by the American Occupational Therapy Association, Inc.
"Insurance Reimbursement Survey Results"
Use of Codes for Diagnosis and Treatment
ICD-9 Diagnostic Codes:
299.0 Autism
299.8 Pervasive Developmental Disorder/Asperger's Syndrome
314.0 Attention Deficit Disorder
314.01 Attention Deficit Disorder with Hyperactivity
315.4 Developmental Coordination Disorder
315.8 Delay in Development (specified)
315.9 Delay in Development (unspecified)
343.9 Cerebral Palsy
759.83 Fragile X Syndrome
781.3 Lack of Coordination
784.69 Motor Apraxis
742.9 Unspecified Anomaly of the Brain, Spinal Cord and Nervous System
349.9 Unspecified Disorders of the Nervous System
782.0 Disturbance of Skin Sensation
781.0 Tremors Nervous system
348.3 Encephalopathy
382.9 Otitis Media
CPT Codes For Billing:
97110 Therapeutic Exercises (procedures)
97112 Neuromuscular Re-Education
97530 Therapeutic Exercises (activities)
97770 Self-Care/Home Management
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In a sample Private OT, these are the evaluation and treatment codes most frequently used...
Evaluation Codes:
96110 OT Eval- developmental assessment interpretation, report
96111 OT Eval- extended standardized developmental instruments
96115 Neurobehavioral status exam with interpretation report
96117 Neuropsychological testing with interpretation report
97003 Medicaid/CMS Evaluation
Treatment Codes:
97110 Therapeutic Procedure - develop strength/endurance. ROM/flex
97112 Neuro-muscular Re-Education - balance, coordination, proprioception
97250 Myofascial Release/Mobilization - hand, wrist
97265 Joint Mobilization - hand, wrist
97504 Orthotics Fitting - upper/lower extremity
(Michelle Morris Reprinted With Permission.)
Michelle Morris is the mother of six, and parent of a child with a
Sensory Processing Disorder. She
is whole heartedly dedicated to promoting awareness and advocacy for families
with SPD children. She has published over 30 articles supporting and
educating parents about SPD.
Related Resources
The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder
- The New York Times calls it the parents bible for Sensory Processing Disorder
Leave Diagnostic Codes For SPD And Return To The Sensory Processing Disorder Home Page
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