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Fwd: CPT Codes for acupuncture

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>CPT Codes

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> CSOM Proposal for Acupuncture CPT Codes Accepted By the AMA.

>

> Acupuncture and other CPT Codes

>

> Below is a brief explaination of CPT codes for acupuncture.

> Following this article there are lists of procedure codes and

>also codes for office visits with descriptions.

>

>

> CSOM often gets calls from people asking about what CPT

>(current procedural terminology) code to use for billing for acupuncture.

>CPT codes are the billing codes that are used for medical procedures. They

>are compiled by the American Medical Association (AMA) and published in a

>book each year. The idea is to have a uniform system to classify medical,

>surgical and diagnostic procedures.

>

> The American Medical Association accepted CSOMs proposal for

>two CPT (current procedural terminology) codes. These are the codes

>established by the AMA that identify medical procedures for insurance

>billing. Thanks to the efforts of CSOM insurance companies and

>practitioners will no longer be clueless about how to code the bills for

>acupuncture. This landmark decision is the equivalent of the American

>Medical Association recognizing acupuncture as a legitimate medical

>procedure. The codes which are 97780 for acupuncture, and 97781 for

>electric-acupuncture, were the result of a year and a half effort by CSOM

>member Ken Cherman, L.Ac. The codes became effective on January 1, 1998.

>This in conjunction with the NIH consensus statement are two big steps

>toward Medicare coverage of acupuncture. The war over coding isn’t over

>but we have won the first big battle.

>

> For regular insurance billing:

>

> Acupuncture 97780

> Electric Acupuncture 97781

>

> To be used only for California Workers Compensation billing

>and allowable charges:

>

> Acupuncture - 97800 - $54.73

> Acupuncture with electro stimulation 97801 - $73.80

> Cupping- 97802 -$19.06

> Moxibustion - 97803 - $19.06

>

> Massage, including effleurage, petrissage and/or tapotement

>(stroking compression or percussion) - 97124

>

> Myofacial Release/ Soft Tissue Mobilization - 97250

>

> Electric Stimulation (does not require direct (one on one)

>patient contact by the Doctor - 97014

>

> Hot / Cold packs- 97010

>

> Diathermy - 97024

>

> Manipulation (cervical, thoracic, lumbosacral, sacroiliac,

>hand, wrist) peformed by physician; one area -97260

>

> Office visit initial - Comprehensive - 99205

> A comprehensive history, a comprehensive examination, medical

>decision making of high complexity. Problems are usually of moderate to

>high severity. Physician typically spends 60 minutes face to face with the

>patient. Examples cited - Lupus patient with fever, seizures and

>thrombocytopenia. 42 year old male with diastolic blood pressure of 110,

>history of renal calculi, episodic headaches, intermitient chest pain and

>orthopnea.

>

>

> Office Visit Initial - Extended - 99204

> A comprehensive history, a comprehensive examination, and

>medical decision making of moderate complexity. Presenting problems of

>moderate to high severity

> Typically 45 minutes face to face with the patient. Example

>cited initial exam for 70 year old female with polyarthalgia, or 63 year

>old man with chest pain on exertion.

>

>

> Office visit initial - Intermediate - 99203

> A detailed history, a detailed exam, medical decision making

>of low complexity.

> Presenting problems are of moderate severity, typically 30

>minutes face to face with the patient. Example cited- initial office visit

>for a 48 year old man with recurrent low back pain radiating to the leg.

>Initial visit with 19 year old football player with 3 day old acute injury

>to the knee: now with swelling and pain

>

> Office visit initial - brief - 99201

> A problem focused history, a problem focused exam,

>straightforward medical decision. Problems are usually self limiting or

>minor. Typically 10 minutes

> Example cited is initial office visit for contusion of a

>finger, or 10 year old with a 24 rash and itching with positive history of

>contact with poison oak withing 48 hrs.

>

>

> Office visit established patient - Brief - 99211

> May not require the presence of a physician. typically 5

>minutes spent. i.e. established patient checks their blood pressure, or

>gets a return to work certificate.

>

> Office visit established patient - - 99212

> A problem focused history, a problem focused exam.

>straightforward medical decision. Problems are usually self limiting or

>minor. Typically 10 minutes face to face with the patient.

>

> Office visit established patient - Intermediate - 99213

> An expanded problem focused history. an expanded problem

>focused examination. Medical decision making of low complexity. Problems

>are of low to moderate severity. Typically 15 minutes spent with the

>patient.

>

> Office visit established patient - 99214

> A detailed history, a detailed examination, medical decision

>making of moderate complexity. Problems of moderate to high severity.

>Typically 25 minutes face to face with the patient.

>

> Office visit established patient - 99215

> A comprehensive history, a comprehensive examination, medical

>decision making of high complexity. Problems are usually of moderate to

>high severity. Physician typically spends 40 minutes face to face with the

>patient.

>

>

>

 

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