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Acupuncture Diagnosis

Annette Posted Thu 01st of August, 2019 17:07:26 PM
Hi! We confirmed with a patient's insurance that they had acupuncture coverage. We billed 97810 and 97811 with dx M54.2, M54.5 and M62.838. They rejected it saying with these dx's if is considered experimental. What dx's could we use? Thanks!
SuperCoder Answered Fri 02nd of August, 2019 03:55:00 AM

Hi Annette,


Acupuncture service is considered as a non covered service as per CMS and Medicare as of Q3, 2019. LCD data also does not provide any ICD-10 CM codes for the provided CPT codes.


If your payer is Non-Medicare, you need to get in touch with your payer to identify the ICD-10 CM codes that can be billed with CPT code 97810 and 97811.


Hope, provided information would be helpful.



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