Acupuncture CPT Codes
Understanding CPT Codes for Acupuncture: A Quick Guide
Navigating the world of medical billing can be complex, especially when it comes to acupuncture and related treatments. This guide aims to clarify the Current Procedural Terminology (CPT) codes relevant to acupuncture, ensuring practitioners and patients alike understand the billing process better.
Acupuncture has become an increasingly popular method for treating a variety of conditions, ranging from chronic pain to stress relief. Understanding the correct CPT codes for billing is crucial for both practitioners and patients to ensure treatments are covered by insurance whenever possible.
Key Points
Acupuncture CPT codes include 97810, 97811, 97813, and 97814.
Related CPT codes, such as those for evaluation and management, dry needling, manual therapy, and therapeutic exercises, can also be relevant.
Proper use of these codes can aid in obtaining insurance reimbursement for acupuncture treatments.
Acupuncture treatment
Acupuncture CPT Codes
Here are the primary CPT codes used for acupuncture treatments:
97810 - Acupuncture, one or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient.
97811 - Acupuncture, one or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles.
97813 - Acupuncture, one or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient.
97814 - Acupuncture, one or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles.
Related CPT Codes
In addition to the primary acupuncture codes, several other CPT codes can be relevant, particularly when treatments are part of a broader therapy plan.
99201 - Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
99202 - Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
99203 - Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making.
99204 - Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate to high level of medical decision making.
99211 - Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified healthcare professional.
99212 - Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
99213 - Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making.
99214 - Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making.
97140 - Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.
Dry Needling CPT Codes
Dry needling, while similar to acupuncture, uses different codes and may be reimbursed differently by insurance companies:
20560 - Needle insertion(s) without injection(s); 1 or 2 muscle(s).
20561 - Needle insertion(s) without injection(s); 3 or more muscles.
Additional Acupuncture-Related CPT Codes
Here are other CPT codes that may be used in conjunction with acupuncture treatments which may not always be covered or approved:
97010 - Application of a modality to one or more areas; hot or cold packs (Heat Therapy).
97016 - Application of a modality to one or more areas; vasopneumatic devices (Cupping).
97026 - Application of a modality to one or more areas; infrared.
97112 - Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception.
97110 - Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion, and flexibility.
97124 - Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion).
97530 - Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes.
Disclaimer
Please note that this list of CPT codes may not be up to date, and different insurance companies may recognize different codes. It is essential to verify with specific insurance providers for the most current and applicable codes to ensure accurate billing and reimbursement.
Conclusion
Understanding and using the correct CPT codes for acupuncture and related therapies is essential for smooth billing processes and insurance reimbursements. By familiarizing yourself with these codes, you can ensure that you receive appropriate compensation for the valuable services provided through acupuncture and associated treatments.
For further assistance and updates, always consult with your billing specialist or insurance provider.
Learn About More Styles of Acupuncture
To discover more about the diverse world of acupuncture and its various methodologies, including Five Element Acupuncture, visit our comprehensive guide on different acupuncture styles: The Ultimate List of Acupuncture Styles. This resource offers a broader understanding of the range and depth of acupuncture practices available, placing Five Element Acupuncture within the context of a rich and varied healing tradition.
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