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Electroanalgesia therapy

Carla Posted Wed 09th of June, 2010 17:13:25 PM

We recently bought an electrical stim therapy machine. We are having trouble coding properly. The rep (of course) told us to code 97014 for the application of the device and then use 97112 for each 15min of therapy.

Can anyone please offer some insite on how to code for these electrical stimulation machines?

SuperCoder Answered Thu 10th of June, 2010 06:29:49 AM

Unattended electrical stimulation is the use of current to facilitate the reduction of pain, edema, and muscle spasm as well as to increase contractile force in the muscles. The type and frequency of current, placement of electrodes and duration of treatment are determined by the clinician.
For Medicare HCPCS code G0283 should be used for unattended electrical stimulation, to one or more areas for indications other than wound care. (Note: CPT code 97014 is considered invalid for Medicare effective 01/01/03).
To know more about how to bill a electrical stimulation see the medicare NCD. See link below...

http://www.cms.gov/mcd/results.asp?show=all&t=201061012310

Carla Posted Thu 10th of June, 2010 14:13:40 PM

Thanks Alex!

Can you also explain what 97112 is? I've read the definition out of the CPT book but it still doesn't make it very clear to me.

Carla

SuperCoder Answered Thu 10th of June, 2010 14:23:52 PM

CPT 97112 is a therapeutic procedures [improve balance, coordination, kinesthetic sense, posture, and proprioception (e.g., proprioceptive neuromuscular facilitation, Feldenkreis, Bobath, BAP’s boards, and desensitization techniques)]which attempt to reduce impairments and improve function through the application of clinical skills and/or services.Use of these procedures require that the practitioner have direct (one-to-one) patient contact. The procedure may be reasonable and medically necessary for impairments that affect the body’s neuromuscular system (e.g., poor static or dynamic sitting/standing balance, loss of gross and fine motor coordination, hypo/hypertonicity).
In physicians’ offices, the “incident to” provisions apply. Do note that the standard treatment is 12 to 18 visits within a four to six week period. Coverage beyond this frequency and duration may require documentation supporting the medical necessity of continued treatment.

Carla Posted Thu 10th of June, 2010 14:32:34 PM

Do you think this code applies to the electrical stim machine? We are being told that we code with 97014 and then 97112 for each appropriate time used. I just don't see how that definition applies to using the electrical stimulation.

Thank you soooo very much for any and all insight.

Carla

SuperCoder Answered Fri 11th of June, 2010 07:50:09 AM

CPT 97014 (For Medicare use G0283) is used when there no direct contact with the pateint and provider but if attended then you need to code 97032. Code 97112 is used when there is a direct contact between the provider and patient. CPT 97014 is a service-based code, only one unit of this code can only be reported once per session, regardless of the number of body parts being treated, because the code descriptor states "application of a modality to one or more areas" here the length of time is not provided on same date of service. But therapeutic procedure (97112) is a time based coding, for example if 24 minutes of neuromuscular reeducation is perfomed then code 2 units of 97112 (one 15-minute block + 9 remaining minutes).
I would suggest that please go through the LCD policies from supercoder for modalities and therapeutic px because individual providers have their own guidelines. Also, do note that these codes are generally auditors favorite, so you need to read individual payer policy before you file any of these claims.

SuperCoder Answered Fri 11th of June, 2010 09:46:53 AM

I forgot to mention that Electric stimulation codes are based upon patients contact with or without any provider. They are 97012, 97014 or G0283. There are certain carrier guidline which consider, when to and when not to bill Electric stimulation codes with therapeutic procedure codes (97110-97116).

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