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2005 CPT CODES
These codes apply for all insurance and worker's comp claims, as filed on HCFA-1500 forms
Old Codes (which are still valid) 97780 acupuncture, one or more needles; without electrical stimulation 97781 acupuncture, one or more needles; with electrical stimulation
New Codes (which allow acupuncturists to bill for time spent in blocks of 15 minutes)
97810 acupuncture, one or more needles, without electrical stimulation, initial 15 minutes of personal one-on-one contact with patient covers time spent with cursory elements of needling process such as charting and explaining (does not include more extensive Evaluation and Management (E & M) such as interviews, palpation, orthopedic manipulations, and/or other testing and exams)
97811 acupuncture, one or more needles, without electrical stimulation, each additional 15 minutes of personal one-on-one contact with patient, including re-insertion covers the insertion of more needles, the use of cupping, gua sha, moxa, etc., and meant to be used in conjunction with 97810 only in order to bill for additional time spent in the needling process or when additional time is needed to perform a medically necessary activity that is a component of the acupuncture treatment (may be used repeatedly)
97813 acupuncture, one or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with patient patient covers time spent with cursory elements of needling process such as charting and explaining (does not include more extensive Evaluation and Management (E & M) such as interviews, palpation, orthopedic manipulations, and/or other testing and exams)
97814 acupuncture, one or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with patient, including re-insertion covers the insertion of more needles, the use of cupping, gua sha, moxa, etc., and meant to be used in conjunction with 97810 only in order to bill for additional time spent in the needling process or when additional time is needed to perform a medically necessary activity that is a component of the acupuncture treatment (may be used repeatedly)
Evaluation & Management examinations and history taking, interviews, palpation, testing, diagnostics, or any other professional services that occur in your office from yourself or any other practitioner of the same specialty who belongs to your group, or practices in your office note: if the E & M examination is done in the same session as the acupuncture treatment, then it must be billed with the modifier, "-25" (for example 99201-25). Otherwise, it may be considered superfluous to the treatment and not be paid by the insurance company.
New Patient E & M Codes “New Patient” means someone brand new to your office, or not seen in 3 or more years
99201 Limited (10 minutes) Presenting problems are self-limited or minor; requires a problem focused history, problem focused examination and straightforward medical decision-making.
99202 Expanded (20 minutes) Presenting problems are of low to moderate severity; requires an expanded problem focused history, an expanded problem focused examination and straightforward medical decision-making.
99203 Detailed (30 minutes) Presenting problems are of moderate severity; requires a detailed history, a detailed examination and medical decision-making of low complexity.
99204 Comprehensive (45 minutes) Presenting problems are of moderate to high severity; requires a comprehensive history, a comprehensive examination and medical decision-making of moderate complexity.
99205 Complex (60 minutes) Presenting problems are of moderate to high severity; requires a comprehensive history, a comprehensive examination and medical decision-making of high complexity
Established Patient E & M Codes 99211 Minimal (5 minutes) Presenting problems are minimal and do not require the presence of a physician. Typically 5 min are spent performing or supervising these services.
99212 Limited (10 minutes) Presenting problems are self-limited or minor, requires a problem-focused history, a problem-focused examination and straightforward decision-making. Physicians typically spend 10 min with patient.
99213 Expanded (15 minutes) Presenting problems are of low to moderate severity, requires an expanded problem-focused history, an expanded problem-focused examination and medical decision-making of low complexity. Physicians typically spend 15 min face-to-face with the patient.
99214 Detailed (25 minutes) Presenting problems are of moderate to high severity, requires a detailed history, a detailed examination, and medical decision-making of moderate complexity. Physicians typically spend 25 min of face-to-face with patient and or family.
99215 Comprehensive (40 minutes) Presenting problems are of moderate to high severity, requires a comprehensive history, a comprehensive examination and medical decision making of high complexity. Physicians typically spend 40 min face-to-face with the patient and/or family.
Here is a link to a 2005 article in Acupuncture Today that describes the process a little more "New CPT Codes For Acupuncture Are Here"
Here are a few more billing codes that may come in handy
97010 BHOT or cold packs therapy 97026 Infrared therapy 97112 Neuro-muscular re-education 97124 Therapeutic massage (15 minute intervals) 97250 Myofascial release
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