Even though acupuncture and holistic healing are old-age methods of getting rid of many medical conditions that even the most modernized and latest medical treatments can’t help humans, it’s only been the last few decades that they have become really famous. So much so that these treatments are now a part of the medical billing, insurance claims can be made against them. This article will take you through some of the most common ICD-10 codes used for acupuncture billing.
A Little Background
Regarding ICD-10 World Health Organization developed the system. Since then, it has been maintained by CDS, also known as the Centers for Disease Control, as the ICD-10 is a relatively newer system. These codes keep getting updated and changed from time to time. These insurance billing codes can easily be downloaded from the CMS official website, which makes it easier for medical practitioners to use them while crafting Acupuncture billing.
As a general rule, it is easy to remember that it’s possible for insurance companies to reimburse pain codes. All kinds of medical treatments granted for internal conditions such as infertility or lupus are, most of the time, rejected. As a matter of fact, the new code set that comes under the category of ICD-10 follows the same rule.
The acupuncture method treats body pains as accepted medical treatments for insurance purposes. Acupuncturists are reimbursed for their services based on diagnosis codes determined by their health insurance providers.
Changes In The New Codes
In 2015, there were changes in the old codes, and new ones were given to the practitioner for medical billing outsourcing. The change was mainly in the number of characters used in these codes. Previously, there were 3 to 5 digits in each code, while the new system has codes that may have as many as 7 characters.
Currently, the total number of codes in the ICD-10 list is 73,639. Among these codes, the most commonly used one requested by acupuncturists for reimbursement is related to lower back pain. This showcases the current health condition of the overall population in the United States and most people dealing with chronic backache problems.
Common ICD-10 Codes To Know About
Though the changing codes may confuse you, there is good news. Some major Current Procedural Terminology codes are here to stay and won’t change. Hence, you can rely on them to get reimbursement. For the medical billing services for small practices, here are some major codes you need to be aware of, as they won’t change. They include:
- 97810: Manual acupuncture, First 15 minutes.
- 97811: Manual acupuncture, additional 15 minutes.
- 97813: Electroacupuncture, first 15 minutes.
- 97814: Electroacupuncture, additional 15 minutes.
For chronic pains, one of the best options to consider is acupuncture. It has proven quite useful in getting rid of the acute ache that didn’t go away even after consistent medical treatment and the popping of pills for many months or years. If you provide acupuncture services and facilities to patients dealing with never-ending pains, billing the therapy requires you to use the following codes:
- G89.0 Central pain syndrome
- G89.11 Acute pain due to trauma
- G89.12 Acute post-thoracotomy pain
- R52 Other acute pain
- G89.21 Chronic pain due to trauma
- G89.28 Other chronic post-operative pain
Another major benefit that expert acupuncturists offer their patients is that relief from muscle pain. A hard injury can lead to some really serious muscle pain, which won’t go away no matter how many surgeries you go under. In this situation, acupuncture becomes medical billing services for small practices, a blessing, removing all the sprain from the muscles, decreasing inflammation, and even making the healing process faster.
The major billing codes used for muscle treatment through acupuncture include:
- M79.6 Myalgia
- M79.7 Fibromyalgia
- M62.40 Muscle spasm
- M60.9 Myositis
For sciatica and other muscle pain issues that won’t go away from consistent medications, acupuncture is a great go-to therapy. Many people prefer it over modernized medical treatments to eliminate chronic back pain. Most of the time, these patients need only three to four sessions of acupuncture and see great improvement in their health.
The major ICD-10 codes used for the muscle pain-relieving acupuncture sessions include:
- M53.0 Cervicocranial syndrome
- M53.82 Other specified dorsopathies
- M54.2 Neck pain
- M54.3 Sciatica
- M54.4 Low back pain
- M54.6 Thoracic spine pain
Contrary to popular belief, acupuncture doesn’t only help with pain relief. Rather, it helps sort a lot of eye, throat, ear, and abdominal issues. For these treatments, the following codes are used when it comes to billing the granted procedures.
- H92.0 Ear pain
- H57.1 Eye pain
- R68.84 Jaw pain
- KOB.9 Tooth pain
- R07.0 Throat pain
- Pain in limb R52
- Rl0.9 Abdominal pain. Unspecified site
- K31.89 Other diseases of stomach and duodenum
- K31.9 Disease of stomach and duodenum, unspecified
These new codes must be used for diagnosis mapping and billing acupuncture treatments. If you keep adhering to the old ones, you will spend a lot of time getting your bills cleared as they would get rejected.
Choosing The Best Insurance Company For Reimbursement
When it comes to medical insurance billing and reimbursement, medical practitioners need to be really careful. This is because certain companies accept a very limited number of diagnoses for reimbursement purposes. Comparatively, Zee medical billing company offers reimbursement for various treatments ranging from neck pain to lower back pain and from nausea from chemotherapy to morning sickness resulting from other medical issues. It is surely the best medical billing company to opt for!
Frequently Asked Questions
ICD-10 codes are used for insurance billing purposes in acupuncture. They help identify specific diagnoses or conditions for which acupuncture treatments are provided, enabling acupuncturists to seek reimbursement from health insurance providers.
ICD-10 codes, or International Classification of Diseases, are used to classify diagnoses, symptoms, and medical conditions. CPT codes, or Current Procedural Terminology codes, are used to identify specific medical procedures or services performed. In acupuncture billing, both ICD-10 and CPT codes are used to ensure accurate documentation and reimbursement.
The ICD-10 code list consists of 73,639 codes in total. However, for acupuncture billing, specific codes related to common conditions treated with acupuncture are used more frequently.
Some commonly used ICD-10 codes for acupuncture billing include:
G89.0: Central pain syndrome, G89.11: Acute pain due to trauma, G89.12: Acute post-thoracotomy pain, R52: Other acute pain, G89.21: Chronic pain due to trauma, G89.28: Other chronic postoperative pain, M79.6: Myalgia (muscle pain), M79.7: Fibromyalgia, M54.2: Neck pain, M54.3: Sciatica, M54.4: Low back pain, M54.6: Thoracic spine pain, H92.0: Ear pain, H57.1: Eye pain, R68.84: Jaw pain, R07.0: Throat pain
The ICD-10 codes can be downloaded from the CMS (Centers for Medicare & Medicaid Services) official website. Acupuncturists can refer to these codes while crafting their acupuncture billing and insurance claims.