Wiki Acupuncture coding

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ms_rnell

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I am looking for information on coding for Acupuncture for a CA work comp case.

Does anybody know if CPT 97800 or 97801 has a "time" increment associated with it in the OMFS? As far as I can tell, these codes have no time requirements unlike the non-work comp CPT codes for the same services. Also, if there is no time associated with them, how/when would it be appropriate to assign CPT 97145 (addn'l time) codes?

I appreciate any help/info that any of you can provide.

Thanks!
 
After looking at the current CPT 2010 book, I do not see these codes listed anymore. 97800/97801 must be discontinued codes. The current codes for Acupuncture are listed as 97810, 97811, 97813, and 97814. These are all time-based codes.

I'm not familiar with CA Work Comp, so maybe there's some special coding with this insurance...??? They should provide you with a list of codes on their fee schedule.
 
I checked and the codes for acupuncture prior to 01/01/2005 were 97780 for one or more needles without electrical stimulation, and 97781 for with electrical stimulation. There was no time element, and that is why these codes were deleted and codes 97810-97814 were created.

So your work comp in CA is still using 2004 codes? I thought my state was behind!

I did look through previous CPT Assistants, but they only talk about how the new codes are time based correctly, whereas the previous codes didn't have that. I wish I could be more help.
 
The codes that you referred me to (97810-97814) are not in the CA Official Medical Fee Schedule for CA worker's comp. The only codes that apply in this situation that are one the OMFS are 97800 or 97801 and I don't see where there is a time element associated with them. However, some of our providers continue to associate the time element of "15 min" with them. This is why I was trying to verify my information before proceeding any further with the providers. Thanks. :)
 
ms_rnell said:
The codes that you referred me to (97810-97814) are not in the CA Official Medical Fee Schedule for CA worker's comp. The only codes that apply in this situation that are one the OMFS are 97800 or 97801 and I don't see where there is a time element associated with them. However, some of our providers continue to associate the time element of "15 min" with them. This is why I was trying to verify my information before proceeding any further with the providers. Thanks. :)
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Sorry - I don't find 97800 or 97801 in previous editions of CPT either; they must be specific codes for CA worker's comp (I did a search of Ingenix archives and can't find them). When I found the previous CPT codes and they didn't have time elements, I thought that was what you were looking for. Sorry I misunderstood.
 
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