CPT Codes for Acupuncture

The New Acupuncture Codes - effective January 1, 200The New Acupuncture Codes - effective January 1, 2005

• 97810 - acupuncture, one or more needles, without electrical stimulation, initial 15 minutes.
• 97811 - acupuncture, one or more needles, without electrical stimulation, each additional 15 minutes, with reinsertion.
• 97813 - acupuncture, one or more needles, with electrical stimulation, initial 15 minutes.
• 97814 - acupuncture, one or more needles, with electrical stimulation, each additional 15 minutes, with reinsertion.
• DO NOT MIX CODES on the same treatment for non-electrical stimulation acupuncture and electrical stimulation acupuncture. If electrical stimulation is used at all in a treatment, only the last two codes should be used.

Reinsertion

• The word was added by the reimbursement update committee.
• Simply means "additional" points are used.
• Must be documented in notes.
• Will insurance companies be looking for reinsertion? Most will not.
• Why? Because TIME is the primary factor.

Applying the New Codes

• New codes are based on amount of time spent with the client.
• Not like the old codes - one code = one treatment.
• new codes allow billing of 97810 and 97811 x1, x2, etc.

TIME Factor

• TIME is the primary factor of new codes.
• TIME means the amount of time spent face to face with the client.
• The work group determined, among other things, new acupuncture codes based on TIME would reflect level of involvement of practitioner.
• More involved cases = more time = additional costs