How do I bill acupuncture for insurance?

When acupuncture is covered, we want to bill for it, so bill for every unit of acupuncture. Acupuncture is billed in 15 minute units, and that is divided into acupuncture with and without electrical stimulation. You can only bill an additional unit of either if you’ve billed the first unit.

Can acupuncture be covered by insurance?

Some health insurance plans cover acupuncture.

But the good news is many large private insurers, such as Aetna, do cover it. … For instance, California’s Medicaid program and insurers like Blue Shield of California cover treatments from a licensed acupuncturist who isn’t a doctor.

What is the modifier for acupuncture?

The most common modifier for acupuncture claims is modifier 25. This modifier is appended to the evaluation and management (E&M) code 99201-99215, to indicate the E&M being reported is separate and distinct from the inherent evaluation associated with the acupuncture services or other treatment of the day.

Can acupuncturists bill E&M codes?

Can an acupuncturist bill for an “office visit” on all visits in addition to the acupuncture codes? No, you may not bill for an “office visit” or more correctly, an evaluation and management service (E&M Codes 99211 through 99215), on each visit.

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What is the CPT code for acupuncture treatment?

CPT® 97811: Acupuncture, one or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with reinsertion of needle(s) (list separately in addition to code for primary procedure).

What should I avoid after acupuncture?

Here’s what to avoid after acupuncture.

  • Strenuous Exercise. You don’t have to avoid exercise altogether, but it would probably be best to slow down a bit. …
  • Caffeine. …
  • Alcohol. …
  • Junk Food. …
  • Ice. …
  • TV and Other Screens.

What is the GP modifier?

The GP modifier indicates that a physical therapist’s services have been provided. It’s commonly used in inpatient and outpatient multidisciplinary settings. It’s also used for functional limitation reporting (FLR), as physical therapists must report G-codes, severity modifiers, and therapy modifiers.

Can an acupuncturist use GP modifier?

For instance, you can code 97026 GP. Most often for acupuncture, only the one modifier is needed but if you ever receive a denial for a therapy being inclusive to another service billed the same date you also want to use modifier 59 to designate that the services were separate and distinct.

What is the CPT code 97110?

CPT code 97110 is defined as “therapeutic exercises to develop strength, endurance, range of motion and flexibility.” It applies to a single or multiple body parts, and requires direct contact with a qualified healthcare professional. … You must also list the specific exercises the performed.

What is the difference between CPT code 99203 and 99204?

Level-4 visits with new patients

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So I’ll round down to a 99203 and keep from attracting some auditor’s attention.” A 99214 requires a detailed history and physical exam, and a 99204 requires a comprehensive history and physical exam. … For a 99204, the past, family and social history must cover all three areas.

How many acupuncture CPT codes are there?

The bulk of the services you will bill to insurance will likely fall under four essential acupuncture CPT codes. Since acupuncture services are always billed in 15-minute increments, your practice will use one code for the initial 15 minutes of service and then a separate code for additional units of time.

What is the CPT code 99212?

99212. Office or other outpatient visit for the evaluation and management of an. established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making.

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