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| 7/6/2022 @ 2:01:00 PM
Post 1 of 6
Contributor: Elisa Perry, Madison County Health Care RHCs
We have a new physician joining our practice that does acupuncture, dry needling and vasectomies. Are any of these billable procedures in the RHC?
10/14/2022 @ 5:24:00 PM
Post 2 of 6
Contributor: Trina Gleese, Newport Health Center
We also have a provider who want to perform acupuncture codes 97813, 97814. I did not see in our coding reference, Craneware, that 0521 was an appropriate revenue code to bill with for these services. If anyone has more information on this, please share!
11/8/2022 @ 9:17:00 AM
Post 3 of 6
Contributor: Toni Young, Gundersen St Josephs Hospital & Clinics RHCs
We have a DO who does acupuncture in the RHC. We have tried billing it as an RHC visit with 521 and it is denied. I had received information from a consultant that 97813 and 97814 were considered RHC visits. When we spoke to Medicare they indicated that it would be paid at the AIR if we submitted correctly but we have tried several different combinations and are still not being paid. Also the denial comes back as not medically necessary even though we have the covered diagnosis from CMS NCD. Effective for services performed on or after January 21, 2020, CMS will cover acupuncture for Medicare patients with chronic Lower Back Pain (cLBP). Up to 12 visits in 90 days are covered for Medicare beneficiaries under the following circumstance:
11/8/2022 @ 10:23:00 AM
Post 4 of 6
Contributor: Andrea Modlin, Hirsch Clinic
Andrea Modlin- CPC, CHRI Charge Data Master Analyst Patient Registration & Accounts Vernon Memorial Healthcare 507 South Main Street Viroqua, WI 54665 PH: 608.637.4232 | amodlin@vmh.org Fax: 608.638.5042 From: NARHC News Sent: Tuesday, November 8, 2022 8:40 AM To: Andrea Modlin Subject: procedures - ThreadID: 19014 ATTENTION: You have received this email from someone outside of Vernon Memorial Healthcare. Please use caution responding, opening attachments or clicking on links. Report this email using the "Phish Alert Report" button in Outlook if you are uncertain, if it asks for an account validation, password reset, or claims to be a security alert. Just for clarification, are they performing Acupuncture or Dry Needling? Acupuncture is used to ease pain or discomfort where Dry Needling is used on trigger points for specific pain. The dry needling codes I believe are Medicare allowable for back pain...CPT 20560-20561. [https://www.narhc.org/images/narhc/Logos/NARHC-logo-narhc-transparent.png] NARHC-News Discussion Forum procedures Most recent 3 replies (Original thread at bottom) Author: From: Toni Young, Revenue Cycle Manager 11/8/2022 8:17:57 AM We have a DO who does acupuncture in the RHC. We have tried billing it as an RHC visit with 521 and it is denied. I had received information from a consultant that 97813 and 97814 were considered RHC visits. When we spoke to Medicare they indicated that it would be paid at the AIR if we submitted correctly but we have tried several different combinations and are still not being paid. Also the denial comes back as not medically necessary even though we have the covered diagnosis from CMS NCD. Effective for services performed on or after January 21, 2020, CMS will cover acupuncture for Medicare patients with chronic Lower Back Pain (cLBP). Up to 12 visits in 90 days are covered for Medicare beneficiaries under the following circumstance: * For the purpose of this decision, cLBP is defined as: * Lasting 12 weeks or longer; * nonspecific, in that it has no identifiable systemic cause (i.e., not associated with metastatic, inflammatory, infectious, etc.disease); * not associated with surgery; and, * not associated with pregnancy. * An additional 8 sessions will be covered for those patients demonstrating an improvement. * No more than 20 acupuncture treatments may be administered annually * Treatment must be discontinued if the patient is not improving or is regressing. ________________________________ Author: From: Trina Gleese, Revenue Cycle 10/14/2022 4:24:19 PM We also have a provider who want to perform acupuncture codes 97813, 97814. I did not see in our coding reference, Craneware, that 0521 was an appropriate revenue code to bill with for these services. If anyone has more information on this, please share! ________________________________ Original Message; see above for most recent replies. Author: From: Elisa Perry, Clinic Director 7/6/2022 1:01:17 PM We have a new physician joining our practice that does acupuncture, dry needling and vasectomies. Are any of these billable procedures in the RHC? ________________________________ Reply by Email ________________________________ You are subscribed to "NARHC-News" as amodlin@vmh.org 11/8/2022 @ 10:25:00 AM
Post 5 of 6
Contributor: Andrea Modlin, Hirsch Clinic
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52863&ver=39&keyword=dry+needling&keywordType=all&areaId=all&docType=NCA
1/31/2023 @ 12:30:00 PM
Post 6 of 6
Contributor: Toni Young, Gundersen St Josephs Hospital & Clinics RHCs
It is acupuncture. Dry needling is done in our rehab department and not in our RHC. Thank you |
