Results 1 to 4 of 4

Acupuncture CPT coding

  1. Default Acupuncture CPT coding
    Exam Training Packages
    I'm posting this here in General Discussion because I didn't see a sub-forum that seemed appropriate for Acupuncture.

    CPT tells us that acupuncture is reported based upon 15-minute increments of personal (face-to-face) contact with the patient. There are codes for with and without electrical stimulation; for purposes of this question, let's forget about electrical stimulation and just use the following:

    97810 - Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient.

    + 97811 - [Acupuncture, 1 or more needles;] without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s).


    Notice that the add-on code for each additional 15 minutes specifies with re-insertion of needle(s). My question is this: How do we code the service if there are more than 15 minutes of face-to-face time but no re-insertion of needles... that is, the initial set of needles are placed, and they are not moved, and no additional needles are introduced?

    We cannot use code 97811, because it requires re-insertion of needle(s). We cannot use 97810 more than once. No other code seems applicable. The use of modifier 22 for extra work seems inappropriate here.

    Any advice?

    Thanks.

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    "Notice that the add-on code for each additional 15 minutes specifies with re-insertion of needle(s). My question is this: How do we code the service if there are more than 15 minutes of face-to-face time but no re-insertion of needles... that is, the initial set of needles are placed, and they are not moved, and no additional needles are introduced?"


    I have the same question. Does anyone have any experience with this?

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    I believe I found the answer. I'm not familiar with this organization but I'm going to post it for a future reference.

    Q: I am confused with the codes for billing acupuncture services. When I do a treatment of acupuncture, I routinely allow the needles to stay in the patient for approximately 30 minutes. During the 30 minutes, I may manipulate the needles two to three times. Considering there is a total of 30 minutes, is it proper to bill 97810 for the first 15 minutes and one unit of 97811 for an additional 15 minutes, considering the total time of 30 minutes?

    A: I will answer the question directly first. No, you may not bill 97811; the only code for what you described is 97810. I understand there has been some confusion as to the use of the codes for acupuncture that has lingered since they changed in 2005. Let's try to clear it up. Acupuncture has four codes to describe specific acupuncture services. While it may appear that each 15 minutes of additional time spent would qualify for the added time, this is an incorrect assumption. The add-on codes of 97811 or 97814 actually are better understood by realizing they are to be used to indicate a new set-up or set of needles being applied, not the time the needles are retained.

    http://acupuncturetoday.com/pdf_out/...1300300778.pdf


    Author's note: Special thanks to American Acupuncture Council for permitting the use of its specific coding examples.

  4. Default
    That does seem to answer the question, thanks.

Similar Threads

  1. Acupuncture Coding - codes be reported
    By dballard2004 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 10-22-2013, 03:49 AM
  2. Acupuncture coding
    By ms_rnell in forum E/M
    Replies: 4
    Last Post: 08-11-2010, 04:27 PM
  3. Coding for Acupuncture
    By ms_rnell in forum Medicare Regulations
    Replies: 0
    Last Post: 08-03-2010, 06:41 PM
  4. Acupuncture Coding
    By sloinvestigator in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 06-23-2008, 08:57 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.