Orthopedic Coding Alert

Question: Medicaid is denying our claims with CPT 97014 . Can you suggest why that might be happening?

Georgia Subscriber

Answer: You might be submitting an incorrect code. Medicare and Medicare HMOs require G0283 (Electrical stimulation [unattended], to one or more areas for indication[ s] other than wound care, as part of a therapy plan of care) instead of 97014 (Application of a modality to 1 or more areas; electrical stimulation [unattended]). Your Medicaid carrier might also follow this guideline, so call your local representative to ask if that's the case.