Darshna Posted Wed 22nd of February, 2017 16:39:34 PM
What Cpt code we can use for bone stim fitting in office setting? Any help will be greatly appreciated
SuperCoder Answered Thu 23rd of February, 2017 01:56:00 AM
Use CPT code 20974 (Electrical stimulation to aid bone healing; noninvasive (nonoperative)).
Medicare argues that there is insufficient evidence to support the medical necessity of using a stimulator for treating nonunions of the skull, vertebrae or those that are tumor-related. And Medicare will not cover ultrasound stimulation for fresh fractures. Coverage guidelines for Medicare may be different from the coverage criteria of many private insurers. Ask your local carriers for more details.
Payers will cover an external bone stimulator for nonunion of long bone fractures; for failed fusion, when a minimum of nine months has elapsed since the last surgery; for congenital pseudarthroses; and as an adjunct to spinal fusion surgery for patients at high risk of pseudoarthrosis due to previously failed fusion at the same site or for those undergoing multiple-level fusion.
Kindly read below mentioned articles for better understanding.