Tip: Report G0281-G0283 to Medicare for unattended stimulation
If your physiatrist performs attended electrical stimulation (97032) but you're reporting unattended electrical stimulation (97014) because you don’t want to attract the OIG’s attention your carrier may notice you bill differently than other PM&R practices which could trigger an audit anyway.
Know When to Report Electrical Stimulation
Although this treatment is neuromuscular electrical stimulation you should not report it using 64565 (Percutaneous implantation of neurostimulator electrodes; neuromuscular).
Electrical stimulation uses an electrical current to cause a single muscle or a group of muscles to contract. By placing electrodes on the skin in various locations the provider can recruit the appropriate muscle fibers to contract and strengthen the affected muscle. The current setting can be changed to allow for a forceful or gentle muscle contraction. Along with increasing muscle strength the contraction of the muscle also promotes blood supply to the area that assists in healing says Marvel Hammer RN CPC CHCO president of MJH Consulting in Denver.
You should report 97032 (Application of a modality to one or more areas; electrical stimulation [manual] each 15 minutes) for electrical treatments that require "constant attendance" and therefore direct patient-to-provider contact according to CPT. You should not report an electrical stimulation code such as 97014 (... electrical stimulation [unattended]) because it refers to a therapy modality that does not require the presence of a clinician.
Note: For Medicare you cannot bill 97014 in any case. You've got to use G0281 (Electrical stimulation [unattended] to one or more areas for chronic stage III and stage IV pressure ulcers arterial ulcers diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care) for wound care and G0282 (Electrical stimulation [unattended] to one or more areas for wound care other than described in G0281) and G0283 (Electrical stimulation [unattended] to one or more areas for indication[s] other than wound care as part of a therapy plan of care) for all other unattended stimulation says Paula Franko PT MCSP owner of Encompass Consulting & Education LLC in Tamarac Fla.
Differentiate 97014 and 97032
Key idea: The biggest difference between 97032 and 97014 is that the therapist or physician must stay with the patient during the treatment to report the attended code (97032). When you're reporting 97032 you're saying that your provider promoted muscle function wound stimulation etc. and was directly involved one-on-one throughout the entire treatment. When you report 97014 the provider sets up the electrodes and then can go and treat someone else Franko says.
Another big difference is that 97014 is not a time-based code so you should only bill it once [...]