The Difference Between Therapeutic Exercise & Therapeutic Activities
Rehabilitation services are often necessary after injury or illness to build strength and improve function. Rehab therapists use many different interventions to address functional limitations. Therapeutic exercise and therapeutic activities are two common interventions that are used to address dysfunction caused by disease and injury. Although both interventions aim to improve function, they are distinctly different.
Rehabilitation therapists document treatment services using CPT -- current procedural terminology -- codes. Each code describes a specific treatment intervention. Therapeutic procedures are a group of CPT codes that require direct, one-on-one interaction between the therapist and the patient. Therapeutic exercise and therapeutic activities are included in this group of CPT codes.
Therapeutic exercise -- CPT code 97110 -- involves instructing a patient in specific exercises to address weakness or loss of joint mobility due to disease or injury. These exercises are not typically functional tasks. For example, overhead shoulder presses using dumbbells is a therapeutic exercise. Stronger shoulders will improve function, however the actual exercise does not mimic an everyday task.
Several types of exercise are included in this category. Active exercise is movement of a body part against gravity, or with additional weight for resistance. Active-assisted exercise is movement of a body part with help from another part of the body -- using one arm to help lift the other, or with help from the therapist. Passive exercise fully relies on the therapist or another part of the patient's body to lift the injured limb.
Therapeutic activities -- CPT code 97530 -- involves the use of functional, dynamic tasks from everyday living to improve range of motion and strength. For example, overhead shoulder movement can be strengthened by reaching up to place a weighted object on a shelf. This is a functional task that directly mimics real-life activity. Therapeutic activities cover a broad range of functional tasks. Movements including pushing, pulling, squatting, bending, lifting, carrying, catching and throwing qualify as therapeutic activities.
Therapeutic exercises are often performed in conjunction with therapeutic activities. For example, after a hip fracture, a person typically has difficulty lifting the injured leg. Therapeutic exercises are performed to strengthen the leg to enable the person to lift it up against gravity. As strength improves, weight is added to the leg to make the exercises more difficult. Therapeutic activities are also performed to improve function. Sit to stand activities continue to improve leg strength while practicing a daily task. Lunging and squatting activities are performed to improve tasks such as laundry and getting in and out of a car.
Therapeutic exercises are sometimes a gateway to therapeutic activities. After shoulder surgery, movement of the arm is often strictly limited for a period of time to protect the repair. However, therapeutic exercises -- usually passive -- begin early in the rehab process to keep the joint from getting stiff. Once the repaired structures have healed, therapeutic activities such as reaching, pushing and pulling are used to restore function.
- Mercer County Community College: Therapeutic Exercise
- Aetna.com: Clinical Policy Bulletin: Physical Therapy Services
- HCMarketplace.com: Coding and Billing for Outpatient Rehab Made Easy -- Proper Use of CPT Codes, ICD-9 Codes, and Modifiers
- American Academy of Orthopaedic Surgeons: Therapy Billing for Beginners
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