Use of CPT code 97533 by Medical coders

Basics of CPT code 97533

In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service helps to stimulate his or her sensory system and assist the brain to process information more effectively. Use one unit of this code for each 15 minutes the provider spends with the patient.

Description of CPT code 97533

97533 Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one on one) patient contact by the provider, each 15 minutes

The qualified health care provider works one-on-one with an individual with sensory integration disorders to provide techniques for enhancing sensory processing and adapting to environmental demands. Sensory integration disorders may be the result of a learning disability, illness, or brain injury. Sensory experiences include touch, movement, body awareness, sight, sound, and the pull of gravity. The process of the brain organizing and interpreting this information is called sensory integration. Sensory integration provides a crucial foundation for later, more complex learning and behavior. This code requires direct contact by a qualified health care provider with the patient and is billed in 15-minute units.

Sensory integrative techniques, as described by CPT code 97533, are techniques performed to enhance sensory processing and promote adaptive responses to environmental demands. These treatments are performed when a deficit in processing input from one of the sensory systems (eg, vestibular, proprioceptive, tactile, visual or auditory) decreases an individual’s ability to make adaptive sensory, motor and behavioral responses to environmental demands. Symptoms of sensory integrative impairments include poor postural responses, anxiety or fear related to movement, poor motor planning, excessive clumsiness, awkward movements, poor coordination of bilateral movements, hypersensitivity, or hyposensitivity.

Individuals in need of sensory integrative treatments demonstrate a variety of problems, including sensory defensiveness, over-reactivity to environmental stimuli, attention difficulties, and behavioral problems. Sensory integration (SI) treatments are often associated with pediatric populations. The most common disorders are autism, developmental disorders, attention deficit disorders, cerebral palsy, and motor apraxia.

Clinical Example for Sensory Integrative Techniques 97533

A child is fearful of walking down the stairs, has poor balance, and has difficulty focusing on a task. Evaluation reveals that the child exhibits difficulty processing vestibular, proprioceptive, and tactile input. The provider engages the child in a variety of activities which provide the appropriate sensory input (eg, heavy touch/pressure with graded movement) to improve the child’s ability to make adaptive motor and behavioral responses and cope with environmental demands. As the child’s sensorimotor and perceptual skills improve, he is able to walk down the stairs with less fear, has better balance and is able to sit longer to attend to a task.

Cognitive impairments are broken down into three categories:

  •  Attentional Impairments
  •  Short Term Memory Impairments
  •  Problem Solving Impairments

Attentional impairments refer to loss of focused, sustained, alternating, and divided attention. Short term memory impairments refer to loss of prospective, declarative, semantic, and episodic memory. Problem solving impairments, which are also known as executive functioning impairments, refer to the inability to initiate a behavioral response, to organize parts of concepts or thoughts into a whole, to sequence thoughts, to having awareness of appropriate behavior and/or decision making, applying judgement and modifying behavior

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