Medical billing is set to be a cut and dry system, but anyone who has used medical coding for billing can attest to the fact that it is not. When billing, it is dire to understand the proper coding in order to prevent payment delays and other issues with patient billing practices that can arise.
To ensure effective compensation for treatments, every medical practice—traditional or holistic—must ensure correct acupuncture billing procedures. Accurate billing codes not only enable insurance companies to pay healthcare providers accurately, but they also produce a legitimate record of patient treatment history.
Since errors can lead to expensive penalties and payment delays, correct acupuncture payment and billing is a crucial sign of a practice’s financial health in the context of holistic services. Up to 80% of medical invoices may contain mistakes due to improper coding and billing, according to some estimates. This can lead to weeks of amending and resubmitting, which delays reimbursement and wastes staff time.
Using the appropriate CPT codes for acupuncture billing while completing claims can offer an effective billing and coding procedure for your comprehensive practice and enable you to prevent a lot of the detrimental effects that frequent billing and coding errors may have.
A growing number of denials and dwindling insurance payments might put your holistic practice at jeopardy if you keep making errors with acupuncture billing codes. A precise acupuncture cpt code and procedures for acupuncture billing will assist guarantee that your holistic clinic makes as much money as it can.
Is There a Complete List of CPT Codes for Acupuncture That I Can Use?
A complete list of CPT codes for acupuncture billing may be something that many acupuncturist offices would want to have on hand. We believe that most insurance companies will reimburse the treatment codes listed below.
The CPT codes for acupuncture are invalid categorized by the three primary revenue streams for your practice: office visits, acupuncture treatments, and modalities and treatments based on physical therapy. Please remember that the plan as well as the employer decides your patient’s insurance coverage; simply knowing the name of the insurance company is insufficient. We recommend you to maintain the list close at hand.
It is usually advised to confirm your patient’s insurance coverage directly with the provider before beginning treatments when billing insurance for acupuncture. Additionally, keep in mind that Medicare (https://www.medicareinteractive.org/get-answers/medicare-basics/medicare-overview/introduction-to-medicare) has unique regulations for acupuncture procedures. It’s critical to maintain precise records to confirm which treatment sessions were performed and why, regardless of who your clinic bills.
Medicare Billing Codes for Acupuncture
On January 21st, acupuncture for persistent low back pain will be covered by the Centers for Medicare and Medicaid Services (CMS) in 2020. This is characterized by lower back discomfort that is localized and lasts longer than three months. Although this ruling was the first time Medicare will pay for acupuncture treatments, there are still conditions that must be met for acupressure services to be eligible.
The following Medicare acupuncture billing codes (at the current Medicare program national average payment schedule) are covered by the current regulations. Remember that the real fees will depend on where the amenities are provided, thus these should be regarded as national averages.
Medical Coding and Billing for Visits to Acupuncture Offices
Acupuncture codes for office visit billing
Office visits, sometimes referred to as assessment and the first patient evaluation and recurring follow-up evaluations may include billing for management services. Every six visits or every 30 days is a decent general rule. The CPT codes 97810, 97813, 97811, and 97814 for acupuncture billing all comprise evaluation and management performed as part of the entire daily therapy; hence it is inappropriate to bill these codes each time the individual receives acupuncture treatments.
It is permissible to use codes 99201 to 99204 when billing a patient with a fresh visit code for the initial occasion you see them. Anyone who has not gotten medical attention from you or someone else in the same field during the last three years is considered a new patient.
A patient who has been established is one who, throughout the previous three years, has received any sort of expert assistance from you or another practitioner in the same field. Once more, charging an established client appointment (codes 99211–99214) on each visit is improper since your regular acupuncture accounting treatment codes already include a daily evaluation component to gauge your patient’s development.
CPT Codes for Acupuncture for New Patients in Your Holistic Practice
Utilize these CPT codes for acupuncture when you take on new clients for your holistic clinic. Recall that a new patient is one who has not received professional services with you or another practitioner in the same specialty during the previous three years and has been a member of your practice.
