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NCCI PTP Practitioner Edits June 2021

PTP Edits-Practitioners: These PTP code pair edits are applied to claims submitted by physicians, non-physician practitioners, and Ambulatory Surgery Center (ASCs). These edits also apply to therapists in private practice and those employed by physicians. 

Updated: June 1, 2021

Physical and Occupational Therapy Evals and Re-evals

    • PT Eval; low complexity
    • PT Eval; med complexity
    • PT Eval; high complexity
    • PT Reevaluation
    • OT Eval; low complexity
    • OT Eval; med complexity
    • OT Eval; high complexity
    • OT Reevaluation

Therapeutic Procedures

    • Therapeutic Exercise
    • Neuromuscular Reeducation
    • Aquatic Therapy
    • Gait Training
    • Massage Therapy
    • Therapeutic Intervention; 15 min
    • Therapeutic Intervention; add 15 min
    • Physical Medicine Procedure
    • Manual Therapy
    • Group Therapy
    • Therapeutic Activities
    • Sensory Integrative Techniques
    • Self-Care Management
    • Community/Work Integration
    • Wheelchair Management Training
    • Work Hardening

Modalities

    • Biofeedback Modality
    • Biofeedback Training; initial 15 minutes
    • Biofeedback Training; each additional 15 minutes
    • Hot or Cold Packs
    • Mechanical Traction
    • Vasopneumatic Devices
    • Paraffin Bath
    • Whirlpool
    • Diathermy
    • Ultraviolet
    • Electrical Stimulation (manual)
    • Iontophoresis
    • Contrast Baths
    • Ultrasound
    • Hydrotherapy
    • Electrical Stimulation (unattended)
    • Electrical Stimulation (Non wound)

Assessments and Orthotics/Prosthetics

    • Range of Motion Measurements
    • Range of Motion; hand
    • Canalith Repositioning
    • Cognitive Testing HC Pro
    • Physical Performance Test
    • Assistive Technology Assessment
    • Orthotic Management
    • Prosthetic Management
    • Orthotic/Prosthetic Management

Wound Care

    • Removal Devitalized Tissue 20cm/<
    • Removal Devitalized Tissue addl 20 cm<
    • Wound Care (non-selective
    • Negative Press Wound tx < 50 cm
    • Negative Press Wound tx > 50 cm
    • Negative Press Wound tx </=50 sq cm
    • Negative Press Wound tx >50 cm
    • Low Frequency, Non-Contact, Ultrasound

Speech Therapy

    • Treatment of Speech; individual
    • Treatment of Speech; group
    • Laryngeal Function Studies
    • Evaluation of Speech Fluency
    • Evaluation of Speech Sound Production
    • Evaluation of Speech with Evaluation of Language Comprehension
    • Behavioral and Qualitative Analysis of Voice and Resonance
    • Treatment of Swallowing Dysfunction
    • Evaluation for Use and/or Fitting of Voice Prosthetic Device
    • Evaluation for Prescription of Speech-Generating AAC Device; first hour
    • Evaluation for Prescription of Speech-Generating AAC Device; each additional 30 minutes
    • Therapeutic Services for Use of Speech-Generating Device
    • Evaluation of Oral and Pharyngeal Swallowing Function
    • Motion Fluoroscopic Evaluation
    • Endoscopic Swallow Evaluation (FEES)
    • Laryngeal Sensory Testing
    • Flexible Fiberoptic Endoscopic Evaluation (FEESST)
    • Assessment of Aphasia


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