Billing and Coding Guidance

Services provided as part major therapeutic/diagnostic decision making.  Services provided in dedicated motion analysis department with these capabilities: 3D kinetics/dynamic electromyography Computerized 3D kinematics Videotaping from front/back/both sides

3D Gait Analysis
CPT® 96001 – 3D Motion test w/ foot pressure analysis
CPT® 96004 – Physician interpretation of motion test

Sensor Medica Systems:

  • Moover Gait + freeMed Walkways + Video Cameras (minimum of 2)
  • Moover Gait + FlexInFit In-Shoe Sensors + Video Cameras (minimum of 2)
  • Moover Gait + Runtime Treadmill + Video Cameras (minimum of 2)

Human motion analysis has several applications including biomedical and athletic performance. To conduct a biomedical analysis, patient movements are recorded, digitized, copied on computer, and processed. For example, when calculating net joint moments, the joint center is calculated using a local coordinate system created from body markers. When tracking markers in 3D using video, two or more cameras are used to identify the markers. After all parameters are found, the resultant net joint forces and movements can be calculated. In 3-D kinematics, joint centers are digitized for the first few frames of the sequence recorded. Linear parameters of movement can be measured to assess horizontal and vertical motion. Also, angular parameters can measure the degrees of movement of the joints to analyze specific joint motion. In 96001, while taking dynamic plantar pressure measurements, data is collected using a pressure sensor platform positioned on a walkway. The patient walks along the walkway so pressure data can be analyzed in areas of the foot (e.g., the heel, metatarsal heads, and the hallux). The peak pressure is determined in all areas and the highest pressure of all sites (i.e., peak pressure foot) is measured. Report 96004 in addition to each of these codes for physician review and interpretation of results, which includes the physician’s written report.

CPT® 96002 – Dynamic surface electromyography, during walking or other functional activities 1-12 muscles

SensorMedica Systems:

  • EMG

Electrodes placed on the muscle belly, parallel to the grain of the muscle fiber, detects an electrical signal that comes from active muscles (the patient is in motion during the test). The strength and pattern of the signal is seen on a computer screen and the data is collected in a software program that is able to run various analyses of the data to create useful reports regarding muscle function. For example, gait analysis allows the clinician to analyze time normal activation patterns separately for stance and swing phases between conditions or against data base values. Report 96002 for a study of one to 12 muscles.

If you have a occupational and/or physical therapists in your office

Assistive Technology Assessment
CPT® 97755 – Bill 2 units
2D Gait assessment, Balance test

Sensor Medica Systems:

  • freeMed Walkways
  • FlexInFit In-Shoe Sensors
  • Runtime Treadmill

A health care provider performs an assessment for the suitability and benefits of acquiring any assistive technology device or equipment that will restore, augment, or compensate for existing functional ability in the patient or that will optimize functional tasks and/or maximize the patient’s environmental accessibility. This code is reported for one-on-one patient contact time, per 15 minutes, and includes the preparation of a written report.

Physical Performance Test
CPT® 97750 – Bill 2 units
Range of Motion

Sensor Medica Systems:

  • Moover One Range of Motion

The health care provider performs a test of physical performance evaluating function of one or more body areas and evaluates functional capacity. A written report is included. This is in addition to a routine evaluation or re-evaluation (9716197172). This code can be reported in 15-minute increments.

Sensormedica does not represent or guarantee that this information is complete, accurate, or applicable to any particular patient or third-party payer. Sensormedica disclaims all liability for any consequence resulting from reliance on this document. The final decision of billing for any service must be made by the health care provider considering the medical necessity of the service furnished as well as the requirements of third-party payers and any local, state, or federal laws and regulations that apply. Sensormedica is providing this information in an educational capacity with the understanding that Sensormedica is not engaged in rendering accounting, or other professional services. Health care providers should consult with their own advisors regarding coding, coverage, and payment.

CPT® copyright 2022 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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