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Billing for Needle-less Acupuncture ?????
Moderator(s): Acuclaims *, Jane Yu
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9/23/2011 at 4:54:39 PM GMT
Posts: 10
Billing for Needle-less Acupuncture ?????

Just got a call from an attorney wanting help because his client was billing for "needle-less" electro acupuncture.  Apparently the client was using a device that electronically stimulates certain areas upon pressure.  The provider used this device to stimulate acupuncture points and then billed for electro- acupuncture, which was denied.


It should have been denied!  The definition of the code used 97813, indicates the use of ONE OR MORE NEEDLES-  Clearly this provider was providing service, but under the CPT code definitions, it was not electro-acupuncture.

11/11/2011 at 1:08:24 AM GMT
Posts: 4
On the same subject, but a different question.  What about acupressure?  I recently received a call recently from a mom who wanted acupressure for her 6 and a half year old daughter, but wasn't sure if/how it could be billed to her insurance company.  It doesn't fall into the definition for the CPT codes. since there is no insertion.

11/11/2011 at 11:03:10 PM GMT
Posts: 10
97140,  is the closest definition of acupressure.  You certainly can't use the needle codes 97810,97811, 97813, 97814,  but I think you have a good case for the acupressure, documenting points and time spent doing the accupressure.  This is the code chiros use for deep tissue, myofascial, trigger point therapy, it is the closest for acupressure.

11/12/2011 at 5:06:06 PM GMT
Posts: 4

Is it appropriate and acceptable to bill our typical acupuncture rates for this code?

11/14/2011 at 6:19:40 PM GMT
Posts: 10
You would bill your rates for 97140, it is also a timed procedure billed in 15 min increments.  NOW unlike the acupuncture codes for the first 15 min - 97810, 97813, there is no "built in office visit, or typical pre & post service associated with the treatment".  So if you did an evaluation/management service it isn't included and can be billed separately from the acupressure.

11/15/2011 at 11:44:37 PM GMT
Posts: 4
If we billed for an exam, does it also require a -25 modifier?

3/14/2012 at 4:43:07 AM GMT
Posts: 10
Sorry Jessica, just saw your question.

All E/M codes require the -25 modifier IF billed with acupuncture.  If no acupuncture is done, no modifier needed.

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