Wiki Help with acupuncture visit

[linda.yazzie2@ihs.gov]

I need help with coding acupuncture procedures with out patient visits.
One provider is seeing patient in out pt setting for pain managements where
he does all documentation of hx, ros & acupuncture which is just acupuncture visit i consider and no payment for that. But if he continues
and order meds than its added e&m w/modifier. Right??

 

[Pam Warren]

The accupuncture visit should document the time, whether or not e-stim was used, the settings, informed consent, locations, patient tolerance, any pre-procedural examination, results, and planned followup.

A separately identifiable E&M can be reported only if the work done is signifcant.....brand new problem, change in medication or treatment plan, or side effects. Just refilling a current med would not be significant enough to report an additional E&M outside what is expected as part of the accupuncture visit.

 

[linda.yazzie2@ihs.gov]

Thank You Pam

 

[sueskuhn]

acupunture question

I will be billing for a group of acupunturists (they are ending the relationship with the current biller) and there is a discussion about whether to bill an E & M code with the follow visit. Some do, some don't. One of the acupuncturists was audited by a local ins carrier. They indicated to her that they weren't sure who needed the education - the provider or the biller.
When the acupunturist reviews what has transpired since the last visit, reviews any changes, improvements, medications, etc and the only exam is taking a pulse, I am not sure there is enough to bill an E & M.
Would like some background on this from others that have billed.
Thanks,

 

[sbryant]

Collection Specialist/Biller

The following questions were propose to me by my family doctor's Acupuncture.

I told her I would do some research and hopefully have the answers she needs. they are as follows:

Does Veterans insurance and other insurance company in general cover acupuncture?

(I was reading that most have a list of what they find acceptable dx for acupuncture)

Do they cover psychological disorders like Anxiety and Depression

and how about:
Insomnia
Menopausal hormonal issues
Menstrual irregularities?
Smoking cessation?
Drug detox?

Is Abdominal pain covered? If yes, would IBS be covered and other digestive disorders?

I read Fibromyalgia has its own code M79.7 is that covered?

Is there specific information I need in the chart to bill for these.... and because I'm working with and getting the referral by Dr P do I go by his charted notes?


Do they cover these CPT codes:
97016 Vasopneumatic Devices (aka cupping)
97026 Infrared Therapy (heat lamp)
97140 Maunual Therpay (TuiNa)
97110 Theraputic exercises
91099 - is for unlisted therapy (can this be billed for Chinese medicine modalities like Gua Sha)

Thanks,
Shirley Bryant, CPC, CBCS

 

[dbardales]

The accupuncture visit should document the time, whether or not e-stim was used, the settings, informed consent, locations, patient tolerance, any pre-procedural examination, results, and planned followup.

A separately identifiable E&M can be reported only if the work done is signifcant.....brand new problem, change in medication or treatment plan, or side effects. Just refilling a current med would not be significant enough to report an additional E&M outside what is expected as part of the accupuncture visit.

I need help with coding acupuncture procedures with outpatient visits. for a patient under workers compensation

please advise