Indego Therapy in Outpatient: Billing Recommendations

When thinking about an exoskeleton, walking often comes to mind. For rehabilitation therapists, however, exoskeletons are used for gait training along with additional therapeutic treatments. Today we are going to discuss additional therapy opportunities using the Indego exoskeleton’s software suites, including Pre-gait, Motion+, and Therapy+, and how you can optimize billing with these different treatments. Please contact your patient’s insurance provider prior to treatment, as some providers may require specific codes for reimbursement with the Indego exoskeleton.

Neuromuscular Reeducation (97112)

  • Pre-gait: Reaching for cones or items of variable size, weight, and height in standing

  • Standing on firm levels and foam surfaces with therapist guarding

  • Throwing and catching a ball

  • Ball toss, light or weighted, to helper

  • Increase challenge with a staggered stance

  • Dynamic reaching activities with Dynavision light board or similar balance technology

  • Therapy+: Weaving around cones or various objects to simulate sharp turns for object navigation at home or in community

Indego Therapy in Outpatient: Billing Reccomendations Parker IndegoIndego Therapy in Outpatient: Billing Reccomendations Parker Indego

Therapeutic Activities (97530)

  • Pre-gait: Static standing tolerance for time

  • Transfer training from various height surfaces including a mat, bed, wheelchair, car

  • Standing at table playing card game or board game with helper

  • Putting away groceries in therapy kitchen

  • Preparing a meal in therapy kitchen

  • Folding laundry while standing

  • Playing hand eye coordination games on Wii Fit using remote control

  • Playing shuffleboard, foosball, Jenga, horseshoes, cornhole while standing

  • Therapy+: Simulate searching for a grocery shopping list with appropriate AD to incorporate cognitive skills

  • Search around clinic for items with increasing difficulty in size or hiding spot; may hide puzzle pieces and incorporate a cognitive challenge by assembling puzzle, or matching shape task for appropriate patients

  • Bowling using therapy equipment (cones or lightweight pins), or community outing to bowling alley. Could use several software suites to complete outing.

  • Community outings to restaurant ordering food, navigating dining room, counting money, walking into and out of business, car transfers. Many software suites could apply to this outing.

 

Indego Therapy in Outpatient: Billing Reccomendations Parker IndegoIndego Therapy in Outpatient: Billing Reccomendations Parker Indego

Therapeutic Exercise (97110)

  • Pre-gait: Performing mini squats with UE support on parallel bars, FWW, or crutches

  • Standing front kicks

  • Toe taps

  • Stepping on/off various platform heights

  • Single leg stepping forward and backward

  • Weight shifting side to side with single leg lifts

  • Upper extremity active range of motion

  • UE static and dynamic resistance training using bands or dumbbells (totals less than 250-pound limit of patient plus weights)

  • core stability with reaching and UE strengthening in standing position

  • Boxing

 

Indego Therapy in Outpatient: Billing Reccomendations Parker IndegoIndego Therapy in Outpatient: Billing Reccomendations Parker Indego

Gait Training (97116) or Gait Training with Orthotics (97660)

  • Therapy+ or Motion+: Gait training over level surfaces with FWW or crutches as appropriate

  • Gait training over unlevel or outside surfaces with AD

  • Navigation up and down ramps and curb cut outs with AD

  • Increasing gait distance, gait speed, or improving gait mechanics

  • Gait training within narrower rooms to simulate home, office, and community scenarios

  • Gait training around park to simulate regular at home exercise routine

 

 

Indego Therapy in Outpatient: Billing Reccomendations Parker Indego

Activities of Daily Living (97535)

  • Pre-gait: Standing at a sink to brush teeth, comb hair, wash face, shave, apply makeup

  • Dressing while sitting, including donning shoes with Indego AFO, donning/doffing jacket while standing

  • Assisting males in performing standing urination per PLOF

  • Household chores such as folding laundry, cleaning counters, dusting, and loading/unloading a dishwasher

  • Making calls on telephone while standing

  • Medication management while standing at a raised table

  • Management of finances for a cognitive challenge while standing in Indego

  • Therapy+ or Motion+: Simulated grocery shopping, with option for patient to create a list for a meal to be prepared in a later session

  • Performing meal preparation in kitchen

 

Indego Therapy in Outpatient: Billing Reccomendations Parker IndegoIndego Therapy in Outpatient: Billing Reccomendations Parker Indego

Community Reintegration (97537)

  • Therapy+ or Motion+: Community outing to the restaurant including navigating doors, dining room seating, ordering from a menu, and money management

  • Car transfers in patient’s vehicle

  • Going shopping at a local mall or shopping center

  • Navigating various surfaces in parking lots, including curb cutouts, graded slopes, grass, and unlevel surfaces

  • Creative and meaningful community outings based on individual’s interest (manicure at the salon, a haircut at the barber, shopping at the patient’s preferred grocery store, bowling, etc.)

 

Other codes may also be appropriate, including Education and Training for Patient Self-Management, PT Evaluation, and PT Reevaluation. Some overlap that exists between activities and clinical judgment is required to correlate specific patient goals with appropriate CPT codes. Please contact the Indego clinical staff for any questions or guidance on implementing the Indego in your therapy sessions!

 

About the Author:

Can an Exoskeleton Help Strengthen My Bones? Michelle Martin Parker IndegoDr. Michelle Martin, PT, DPT, is a Neuro-IFRAH certified physical therapist for the Janz Corporation, a Service Disabled Veteran Owned Small Business. Michelle graduated Summa Cum Laude with a Bachelor’s Degree in Psychology from The University of Tennessee at Chattanooga where she continued her education to become a Doctor of Physical Therapy. Michelle has worked with patients with neurological, orthopedic, cardiopulmonary, and geriatric related impairments. She enjoys helping patients progress and find creative ways to overcome their barriers to mobility. Michelle hiked 2,190 miles of the Appalachian Trail from Georgia to Maine and cherishes her role as an Indego Instructor in-training where she is able to help individuals with mobility impairments enjoy the freedom of walking.

 

Related articles:

Introduction to Indego Motion+ and Therapy+

Can an Exoskeleton Help Strengthen My Bones?

Which Exoskeleton is Right for Me?

Introduction to Advanced Gait

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