 | |  | |  |
CPT Procedure Codes As of April 1, 2007, all claims submitted to insurance companies are required to be printed on the new HCFA form. The old form will no longer be accepted. The new form requires use of your NPI in reference to the provider/practitioner and those who refer patients to the provider. After May 23, 2007, all submitted CMS-1500 forms must include an NPI number. National Provider Identifier (NPI) To obtain an NPI for free and acquired instantly through the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System. Online, go to: https://nppes.cms.hhs.gov/NPPES/Welcome.do Or call 1-800-465-3203. Below are the codes currently available to Acupuncturist's and a brief explanation as to how to use them. CPT Codes 99201-205 Initial Office Consultation (not treatment) 99211-215 Review Office Consultation (not treatment) 97810 Acupuncture without Electrical Stimulation - 15 minutes 97811 Acupuncture without Electrical Stimulation - Additional 15 mins 97813 Acupuncture with Electrical Stimulation - 15 Minutes 97814 Acupuncture with Electrical Stimulation - Additional 15 Minutes 99201-05 & 99211-15: These can be used by most practitioners including MDs, Chiropractors and Acupuncturists. It does not include treatment, it is simply the time spent in assessing a patient's condition and doing an intake. The first is for the initial intake, the second is if you spend a lot of time doing a re-assessment of the patient. 97810 & 97811: These two codes go together. 97810 is your general Acupuncture treatment code. It includes 15 mintues of actual time with a patient performing treatment. 97811 is for any additional 15 minutes spent administering treatment (not the time the patient is marinating on the table). You cannot use 97811 without using 97810 first. For example, if you just do a front treatment and nothing else, use 97810. If you do both a front and back treatment, you should use both codes. 97813 & 97814: These codes are used identically as 97810-11 except they are for when you use electrical stimulation on one or more needles. Again, the first 15 minutes of treatment are covered under 97813 and then only if you do additional needling with stim should you use 97814 (in addition to 97813). Similar to diagnosis, there are no codes specific to acupuncture services that are affected in the 2008 edition. Specifically, acupuncture and physical medicine services have no changes. There are updates to medical conferences and phone calls, as well as language updates for modifiers. Telephone Calls (99371, 99372 and 99373) have been deleted in 2008 and are now coded as follows: Telephone Services 99441 Telephone evaluation and management service provided by a physician to an established patient, parent or guardian not originating from a related E/M service provided within the previous seven days nor leading to an E/M service within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. 99442 11-20 minutes of medical discussion. 99443 21-30 minutes of medical discussion. Team Conferences 99360 and 99361 have been deleted in 2008 and are now coded as follows: 99366 Medical Team Conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more; participation by nonphysician, qualified health care professional. Team conferences of less than 30 minutes not reported separately. 99367 Medical Team Conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician. 99368 participation by nonphysician, qualified health care professional Team conferences of less than 30 minutes not reported separately. Modifiers –25 and –59 The explanatory language of these modifiers was revised to remove the term physician in the opening sentence to avoid prohibiting designated individuals (as defined by payment programs) to use the modifier. For example: chiropractors, acupuncturists, physical therapists and occupational therapists. Modifier –51 Language was revised so that usage of modifier–51 is not applicable to physical medicine and rehabilitation services. Therefore, it should not be needed for an acupuncture service. We cannot list here the amount you should charge for any of the above services. Use your own judgement and be fair. For more information about insurance billing click here |
| IF AN INSURER REFUSES TO COVER ACUPUNCTURE OR ORIENTAL MEDICAL TREATMENT -- Click Here |
| New ICD-9-CM codes for 2008 For free downloadable codes visit: http://icd9coding.com/ |
