Wiki Dry Needling Physical Therapy

[mthomas-gedig]

I was wondering what other coders are using to show trigger point dry needling?
Our therapists have been using 97140 but I was unsure if that was correct.
I read a letter from APTA and it looked like they may have recommended using 97799.
Does anyone have any experience or knowledge on coding and reimbursement for this technique?
Thank you!!
Misty Thomas-Gedig, CPC-A

 

[kivbar16]

I would check your payer policies. I don't think Medicare covers Dry Needling as a PT service.

 

[kdean31]

Dry Needling

I was wondering what other coders are using to show trigger point dry needling?
Our therapists have been using 97140 but I was unsure if that was correct.
I read a letter from APTA and it looked like they may have recommended using 97799.
Does anyone have any experience or knowledge on coding and reimbursement for this technique?
Thank you!!
Misty Thomas-Gedig, CPC-A

The APTA suggests that PTs first check with their insurance payers to see if they have a dry needling billing policy and/or specific code(s) they prefer you use on your claims. If you don’t take this step, you’re basically taking a shot in the dark and hoping they’ll reimburse you for services rendered—not a good plan. However, if a payer doesn’t have a policy and/or preferred code, never use CPT code 97140 when billing for dry needling. Instead, the APTA advises that you “report the service using the appropriate unlisted physical medicine/rehabilitation service or procedure code 97799.” WebPT

Kathy Dean, CPMA, CPC, COC, CPC-P, CCS-P

 

[kmdubiel@gmail.com]

Dry Needling

We currently use 97799, unlisted physical medicine procedure but it is not covered in most instances. We are currently receiving push back from our PT department, stating they have discussed with APTA billing experts who advise they can use manual therapy 97140 or even E-stim 97032 or Neuromuscular re-ed 97112 in some cases. I have not found anything to support this and still feel 97799 is most accurate.
I am also curious if others have come across this?
Thank you,
Kari Kotewa, CPC

 

[acooper1]

You really are at the mercy of the payers. Here in Maine, we have payers wanting different things.

Medicare/Medicaid consider dry-needling and acupuncture to be one in the same. Anthem wants us to use 97139 specifically, which will count toward a patient's PT benefit usage. Aetna and Cigna consider dry needling experimental and investigational and will not consider it, but may consider acupuncture for payment, with limitations. Do your digging with your local payers, but there isn't always a blanket answer to these types of inquiries.

Hope this helped some!

Amber Cooper, CPC-A