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Please Read Health Insurance Reimbursement Tips on TACA's Website. It has great information on medical codes (including codes for biomedical treatment) and on the coding process.
Please note: Insurance coding is a tricky area. Different insurance carriers may accept/require different codes. I recommend that you ask your child's various therapists for the codes they typically use. Here are some codes that may be helpful:
|
| Diagnostic Codes related to Occupational Therapy |
| 279.11 |
DiGeorge Syndrome |
| 299.00 |
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 - Dyspraxia |
| 315.8 |
Delay in Development (specified) |
| 315.9 |
Delay in Development (unspecified) |
| 343.9 |
Cerebral Palsy |
| 348.3 |
Encephalopathy |
| 349.9 |
Unspecified Disorders of the Nervous System |
| 374.44 |
Sensory Processing Disorder |
| 382.9 |
Otitis Media |
| 742.9 |
Unspecified Anomaly of the Brain, Spinal Cord and Nervous System |
| 759.83 |
Fragile X Syndrome |
| 781.3 |
Lack of Coordination - Dyspraxia |
| 781.0 |
Tremors Nervous System |
| 782.0 |
Disturbance of Skin Sensation |
| 784.69 |
Motor Apraxia |
| Evaluation Codes related to Occupational Therapy |
| 96110 |
OT Evaluation - Developmental Assessment Interpretation, Report |
| 96111 |
OT Evaluation - Extended Standardized Developmental Instruments |
| 96115 |
Neurobehavioral Status Exam with Interpretation Report |
| Treatment Codes related to Occupational Therapy |
| 97110 |
Therapeutic Procedure - Develop Strength/Endurance, ROM |
| 97112 |
Neuromuscular Re-Education - Balance, Coord., proprio. |
| 97530 |
Therapeutic Activities - Improve Functional Performance |
| 97533 |
Sensory Integration Techniques |
| 97535 |
Self - Care/ADL Training |
| Diagnostic Codes related to Speech and Language Therapy |
| 299.9 |
Unspecified Pervasive Developmental Disorder (PDD-NOS) |
| 299.00 |
Autism |
| 314.01 |
Attention Deficit, Childhood with Hyperactivity |
| 315.31 |
Language Disorder, Dev. -Aphasia, Word Deafness |
| 315.39 |
Articulation Disorder, Dev. -Dyslalia |
| 388.4 |
Auditory Perception, Abnormal |
| 784.4 |
Voice Disorder |
| 784.69 |
Apraxia |
| 787.2 |
Dysphagia |
| Evaluation and Treatment Codes related to Speech and Language Therapy |
| 92506 |
Evaluation of Speech, Language, Voice, Communication, Auditory Processing and/or Aural Rehabilitation Status |
| 92507 |
Treatment of Speech, Language, Voice, Communication, Auditory Processing, Individual Therapy |
| 92508 |
Group, Two or More Individuals |
| 97532 |
Development of Cognitive Skills to Improve Attention, Memory, Problem Solving, Direct One-on-One Patient Contact by the Provider |
| 97533 |
Sensory Integrative Techniques to enhance sensory Processing and Promote Adaptive Responses to Environmental Demands |
| 92520 |
Laryngeal Function Studies |
| 96105 |
Assessments of Aphasia |
| 96110 |
Developmental Testing, Limited, with Interpretation and Report |
| Swallowing Function |
| 92526 |
Treatment of Swallowing Dysfunction and/or Oral Function for Feeding |
| 92610 |
Evaluation of Swallowing Function |
| Diagnostic Codes related to Applied Behavioral Analysis |
| 299.00 |
Autism |
| Treatment Codes related to Applied Behavioral Analysis |
| You will find that ABA providers will use different codes. Ask your provider if they already have codes that they have used successfully. If not, the following codes may help. For a full description, you can look up these codes at the AMA website. |
| 90808 |
Director Level |
| 90806 |
Tutor Level |
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Insurance Help for California Families 
