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G0282
|
HC ELECTRICAL STIMULATION, TO ONE OR MORE AREAS, FOR WOUND CARE
|
HCPCS
|
Electromagnetic therapy for the treatment of wounds is considered investigational. The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
Electromagnetic therapy for the treatment of wounds is considered investigational. The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care.
|
G0295
|
Electromagnetic therapy onc
|
HCPCS
|
Electromagnetic therapy for the treatment of wounds is considered investigational. The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care.
|
E0761
|
Nontherm electromgntc device
|
HCPCS
|
The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device.
|
G0282
|
HC ELECTRICAL STIMULATION, TO ONE OR MORE AREAS, FOR WOUND CARE
|
HCPCS
|
The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device.
|
G0295
|
Electromagnetic therapy onc
|
HCPCS
|
The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
The following HCPCS codes are available for this treatment:
G0281: Electrical stimulation (unattended), to one or more areas, for chronic stage III and stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care. G0282: Electrical stimulation (unattended), to one or more areas, for wound care other than described in G0281. G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device.
|
E0761
|
Nontherm electromgntc device
|
HCPCS
|
G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation.
|
G0295
|
Electromagnetic therapy onc
|
HCPCS
|
G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation.
|
E0769
|
Electric wound treatment dev
|
HCPCS
|
G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
G0295: Electromagnetic therapy, to one or more areas, for wound care other than described in G0329 or for other uses. G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation.
|
E0761
|
Nontherm electromgntc device
|
HCPCS
|
G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032.
|
E0769
|
Electric wound treatment dev
|
HCPCS
|
G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032.
|
97032
|
TENS APPLICATION CONSTANT SUP
|
HCPCS
|
G0329: Electromagnetic therapy, to one or more areas, for chronic stage III or stage IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care. E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032.
|
E0761
|
Nontherm electromgntc device
|
HCPCS
|
E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable.
|
97032
|
TENS APPLICATION CONSTANT SUP
|
HCPCS
|
E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable.
|
E0769
|
Electric wound treatment dev
|
HCPCS
|
E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
E0761: Non-thermal pulsed high-frequency radiowaves, high peak power electromagnetic energy treatment device. E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable. The Medicare policy notes that coverage for electrical stimulation is limited to supervised settings.
|
E0769
|
Electric wound treatment dev
|
HCPCS
|
E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable. The Medicare policy notes that coverage for electrical stimulation is limited to supervised settings.
|
97032
|
TENS APPLICATION CONSTANT SUP
|
HCPCS
|
E0769: Electrical stimulation or electromagnetic wound treatment device, not otherwise classified. The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable. The Medicare policy notes that coverage for electrical stimulation is limited to supervised settings.
|
G0281
|
PR ELEC STIM UNATTEND FOR PRESS
|
HCPCS
|
The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable. The Medicare policy notes that coverage for electrical stimulation is limited to supervised settings. Although the terminology is confusing, for the purposes of Medicare policy, supervised is interpreted to mean that while a physician or other health professional is supervising the treatment, this person does not have to be in constant attendance.
|
97032
|
TENS APPLICATION CONSTANT SUP
|
HCPCS
|
The HCPCS code G0281 (unattended electrical stimulation) was specifically developed to make a distinction between attended and unattended electrical stimulation. Attended electrical stimulation is identified by CPT code 97032. Although the description of this CPT code is nonspecific and could describe any type of electrical stimulation, electrical stimulation for wound healing would not require constant attendance, and thus the CPT code would not be applicable. The Medicare policy notes that coverage for electrical stimulation is limited to supervised settings. Although the terminology is confusing, for the purposes of Medicare policy, supervised is interpreted to mean that while a physician or other health professional is supervising the treatment, this person does not have to be in constant attendance.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
2004; www.cms.hhs.gov. Accessed July, 2014. |CPT||See Policy Guidelines|
|ICD-9||707.00-707.9||Chronic ulcer of skin, code range|
|HCPCS||See Policy Guidelines|
|ICD-10-CM (effective 10/1/15)||Investigational for all wounds|
|E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622||Various types of diabetes with skin complications (foot ulcer or other skin ulcer) code list|
|I83.001-I83.029; I83.201-I83.229||Varicose veins with ulcer code range|
|L00 – L08.9||Infections of the skin code range (includes cellulitis – L03)|
|L89.00-L89.95||Pressure ulcer code range|
|L97.10-L97.929||Non-pressure chronic ulcer of skin code range|
|L98.41-L98.499||Non-pressure chronic ulcer of skin not otherwise classified code range|
|L99||Other disorders of skin and subcutaneous tissue in diseases classified elsewhere|
|ICD-10-PCS (effective 10/1/15)||ICD-10-PCS codes are only used for inpatient services. There is no specific ICD-10-PCS code for the initiation or application of this therapy.|
Alternative Current (AC), Electrical Stimulation, Wounds Electrical Stimulation, Wounds
Electrostimulation and Electromagnetic Therapy
High Voltage Pulsed Current (HVPC)
Low Intensity Direct Current (LIDC), Wounds
Transcutaneous Electrical Nerve Stimulation (TENS), Treatment of Wounds
Ulcers, Electrical Stimulation
Wounds, Electrical Stimulation
|07/17/03||Add policy to Medicine section||New policy|
|04/1/05||Replace policy||Policy updated with February 2005 TEC Assessment; policy statement on electrical stimulation of wounds in now considered investigational. HCPCS code G0329 added to policy guidelines|
|04/25/06||Replace policy||Literature review update for the period of February 2005 through February 2006; reference number 4 added.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
Accessed July, 2014. |CPT||See Policy Guidelines|
|ICD-9||707.00-707.9||Chronic ulcer of skin, code range|
|HCPCS||See Policy Guidelines|
|ICD-10-CM (effective 10/1/15)||Investigational for all wounds|
|E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622||Various types of diabetes with skin complications (foot ulcer or other skin ulcer) code list|
|I83.001-I83.029; I83.201-I83.229||Varicose veins with ulcer code range|
|L00 – L08.9||Infections of the skin code range (includes cellulitis – L03)|
|L89.00-L89.95||Pressure ulcer code range|
|L97.10-L97.929||Non-pressure chronic ulcer of skin code range|
|L98.41-L98.499||Non-pressure chronic ulcer of skin not otherwise classified code range|
|L99||Other disorders of skin and subcutaneous tissue in diseases classified elsewhere|
|ICD-10-PCS (effective 10/1/15)||ICD-10-PCS codes are only used for inpatient services. There is no specific ICD-10-PCS code for the initiation or application of this therapy.|
Alternative Current (AC), Electrical Stimulation, Wounds Electrical Stimulation, Wounds
Electrostimulation and Electromagnetic Therapy
High Voltage Pulsed Current (HVPC)
Low Intensity Direct Current (LIDC), Wounds
Transcutaneous Electrical Nerve Stimulation (TENS), Treatment of Wounds
Ulcers, Electrical Stimulation
Wounds, Electrical Stimulation
|07/17/03||Add policy to Medicine section||New policy|
|04/1/05||Replace policy||Policy updated with February 2005 TEC Assessment; policy statement on electrical stimulation of wounds in now considered investigational. HCPCS code G0329 added to policy guidelines|
|04/25/06||Replace policy||Literature review update for the period of February 2005 through February 2006; reference number 4 added. Policy statement unchanged|
|04/17/07||Replace policy||Policy updated with literature review; policy statement unchanged|
|05/08/08||Replace policy||Policy updated with literature review; references 5-7 added; policy statements unchanged|
|10/06/09||Replace policy||Policy updated with literature review; policy statement unchanged; reference 2 removed and others renumbered; new reference 7 added.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
|CPT||See Policy Guidelines|
|ICD-9||707.00-707.9||Chronic ulcer of skin, code range|
|HCPCS||See Policy Guidelines|
|ICD-10-CM (effective 10/1/15)||Investigational for all wounds|
|E08.621, E08.622, E09.621, E09.622, E10.621, E10.622, E11.621, E11.622, E13.621, E13.622||Various types of diabetes with skin complications (foot ulcer or other skin ulcer) code list|
|I83.001-I83.029; I83.201-I83.229||Varicose veins with ulcer code range|
|L00 – L08.9||Infections of the skin code range (includes cellulitis – L03)|
|L89.00-L89.95||Pressure ulcer code range|
|L97.10-L97.929||Non-pressure chronic ulcer of skin code range|
|L98.41-L98.499||Non-pressure chronic ulcer of skin not otherwise classified code range|
|L99||Other disorders of skin and subcutaneous tissue in diseases classified elsewhere|
|ICD-10-PCS (effective 10/1/15)||ICD-10-PCS codes are only used for inpatient services. There is no specific ICD-10-PCS code for the initiation or application of this therapy.|
Alternative Current (AC), Electrical Stimulation, Wounds Electrical Stimulation, Wounds
Electrostimulation and Electromagnetic Therapy
High Voltage Pulsed Current (HVPC)
Low Intensity Direct Current (LIDC), Wounds
Transcutaneous Electrical Nerve Stimulation (TENS), Treatment of Wounds
Ulcers, Electrical Stimulation
Wounds, Electrical Stimulation
|07/17/03||Add policy to Medicine section||New policy|
|04/1/05||Replace policy||Policy updated with February 2005 TEC Assessment; policy statement on electrical stimulation of wounds in now considered investigational. HCPCS code G0329 added to policy guidelines|
|04/25/06||Replace policy||Literature review update for the period of February 2005 through February 2006; reference number 4 added. Policy statement unchanged|
|04/17/07||Replace policy||Policy updated with literature review; policy statement unchanged|
|05/08/08||Replace policy||Policy updated with literature review; references 5-7 added; policy statements unchanged|
|10/06/09||Replace policy||Policy updated with literature review; policy statement unchanged; reference 2 removed and others renumbered; new reference 7 added. Policy guidelines section revised.|
|10/08/10||Replace policy||Policy updated with literature review; no other changes to policy statements; Rationale rewritten; reference numbers 4-6 added.|
|10/11/12||Replace policy||Policy updated with literature review; policy statements unchanged.
|
G0329
|
PR ELECTROMAGNTIC TX FOR ULCERS
|
HCPCS
|
There is no specific ICD-10-PCS code for the initiation or application of this therapy.|
Alternative Current (AC), Electrical Stimulation, Wounds Electrical Stimulation, Wounds
Electrostimulation and Electromagnetic Therapy
High Voltage Pulsed Current (HVPC)
Low Intensity Direct Current (LIDC), Wounds
Transcutaneous Electrical Nerve Stimulation (TENS), Treatment of Wounds
Ulcers, Electrical Stimulation
Wounds, Electrical Stimulation
|07/17/03||Add policy to Medicine section||New policy|
|04/1/05||Replace policy||Policy updated with February 2005 TEC Assessment; policy statement on electrical stimulation of wounds in now considered investigational. HCPCS code G0329 added to policy guidelines|
|04/25/06||Replace policy||Literature review update for the period of February 2005 through February 2006; reference number 4 added. Policy statement unchanged|
|04/17/07||Replace policy||Policy updated with literature review; policy statement unchanged|
|05/08/08||Replace policy||Policy updated with literature review; references 5-7 added; policy statements unchanged|
|10/06/09||Replace policy||Policy updated with literature review; policy statement unchanged; reference 2 removed and others renumbered; new reference 7 added. Policy guidelines section revised.|
|10/08/10||Replace policy||Policy updated with literature review; no other changes to policy statements; Rationale rewritten; reference numbers 4-6 added.|
|10/11/12||Replace policy||Policy updated with literature review; policy statements unchanged. References 3 and 8 added; other references renumbered or removed.|
|10/10/13||Replace policy||Policy updated with literature review through September 5, 2013; policy statements unchanged.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
The Healthcare Common Procedure Coding System (HCPCS) is a two-tiered system that includes Common Procedure Terminology, at Level I, which is usually referred to as CPT codes. More specialized codes are used for reporting services to Medicare and other payers at Level II. Since these codes do not have an equivalent in any other manual but the Center for Medicare and Medicaid Services HCPCS manual, these codes are referred to as HCPCS in the field, to differentiate them from the more universal CPT codes. The use of HCPCS for all medical transactions was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPPA). While HIPPA established a number of regulations governing the transmission of Protected Health Information (PHI), its enactment also mandated the use of the same codes across the industry to describe medical procedures.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
More specialized codes are used for reporting services to Medicare and other payers at Level II. Since these codes do not have an equivalent in any other manual but the Center for Medicare and Medicaid Services HCPCS manual, these codes are referred to as HCPCS in the field, to differentiate them from the more universal CPT codes. The use of HCPCS for all medical transactions was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPPA). While HIPPA established a number of regulations governing the transmission of Protected Health Information (PHI), its enactment also mandated the use of the same codes across the industry to describe medical procedures. For this reason, both medical billers and medical coders need a solid understanding of how these codes are meant to be used, the kind of understanding that can only be gained through a formal education program of study.
|
0212
|
Other Inpatient
|
RC
|
University of Michigan Health System
1500 E. Medical Center Drive
Ann Arbor, MI 48109
Sherman Leis, D.O., F.A.C.O.S. The Center For Plastic And Reconstructive Surgery
19 Montgomery Avenue
Bala Cynwyd, PA 19004
Ellie Zara Ley, MD
7025 N. Scottsdale Rd, Suite 302
Scottsdale, AZ 85253
Christine McGinn, MD
Papillon Gender Wellness Center
18 Village Row
New Hope, PA 18938
Toby R Meltzer, MD, PC
7025 N. Scottsdale Rd, Suite 302
Scottsdale, AZ 85253
Tuan A. Nguyen, M.D., D.D.S. 15820 Quarry Road
Lake Oswego, OR 97035
Harold M. Reed, M.D., F.I.C.S. 1111 Kane Concourse
Bay Harbor, Florida 33154
Kathy Rumer, MD, FACOS
Rumer Cosmetic Surgery
105 Ardmore Avenue
Ardmore, PA 19003
575 Sir Francis Drake Blvd
Greenbrae, CA 94904
University Plastic Surgery, 9000 Waukegan Rd, Suite 210,
Morton Grove, IL, 60053, US
Christopher Salgado, MD
1120 NW 14th Street
Miami, FL 33136
9884 South Santa Monica Blvd
Beverly Hills, CA 90212
Heidi Wittenberg, MD
Urogynecology Center of San Francisco
55 Francisco Street, #300
San Francisco, CA 94133
NEW! DR. RIAN MAERCKS, M.D.
|
0079U
|
Comparative Deoxyribonucleic Acid (DNA) analysis using multiple selected Single-Nucleotide Polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
|
CPT
|
Additionally, the AMA updates CPT® nomenclature, or medical language, to reflect advances in medicine. Although the AMA owns the copyright to CPT®, it invites providers and organizations to participate in the ongoing maintenance of the code set, welcoming those who use it to suggest changes to codes and code descriptors. Recognizing CPT® Codes
CPT® codes consist of 5 characters. The majority of codes are numeric, but some codes have a fifth alpha character, such as F, T, or U. Examples include
- 33275—Transcatheter removal of permanent leadless pacemaker, right ventricular
- 3006F—Chest X-ray results documented and reviewed (CAP)
- 0510T—Removal of sinus tarsi implant
- 0079U—Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
Understanding the Types of CPT® Codes
Coders assign a code for every service or procedure a provider performs.
|
0079U
|
Comparative Deoxyribonucleic Acid (DNA) analysis using multiple selected Single-Nucleotide Polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
|
CPT
|
Recognizing CPT® Codes
CPT® codes consist of 5 characters. The majority of codes are numeric, but some codes have a fifth alpha character, such as F, T, or U. Examples include
- 33275—Transcatheter removal of permanent leadless pacemaker, right ventricular
- 3006F—Chest X-ray results documented and reviewed (CAP)
- 0510T—Removal of sinus tarsi implant
- 0079U—Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
Understanding the Types of CPT® Codes
Coders assign a code for every service or procedure a provider performs. CPT® even includes codes called unlisted codes for those services and procedures not specifically named in another defined CPT® code. Given the vast number of services and procedures, the AMA has organized CPT® codes logically, beginning with classifying them into three types.
|
0079U
|
Comparative Deoxyribonucleic Acid (DNA) analysis using multiple selected Single-Nucleotide Polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
|
CPT
|
The majority of codes are numeric, but some codes have a fifth alpha character, such as F, T, or U. Examples include
- 33275—Transcatheter removal of permanent leadless pacemaker, right ventricular
- 3006F—Chest X-ray results documented and reviewed (CAP)
- 0510T—Removal of sinus tarsi implant
- 0079U—Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
Understanding the Types of CPT® Codes
Coders assign a code for every service or procedure a provider performs. CPT® even includes codes called unlisted codes for those services and procedures not specifically named in another defined CPT® code. Given the vast number of services and procedures, the AMA has organized CPT® codes logically, beginning with classifying them into three types. - CPT® Category I —the largest body of codes consisting of those commonly used by providers to report their services and procedures
- CPT® Category II —supplemental tracking codes used for performance management
- CPT® Category III —temporary codes used to report emerging and experimental services and procedures
Navigating Category I Codes
Most CPT® codes are Category I codes.
|
0079U
|
Comparative Deoxyribonucleic Acid (DNA) analysis using multiple selected Single-Nucleotide Polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
|
CPT
|
Examples include
- 33275—Transcatheter removal of permanent leadless pacemaker, right ventricular
- 3006F—Chest X-ray results documented and reviewed (CAP)
- 0510T—Removal of sinus tarsi implant
- 0079U—Comparative DNA analysis using multiple selected single-nucleotide polymorphisms (SNPs), urine and buccal DNA, for specimen identity verification
Understanding the Types of CPT® Codes
Coders assign a code for every service or procedure a provider performs. CPT® even includes codes called unlisted codes for those services and procedures not specifically named in another defined CPT® code. Given the vast number of services and procedures, the AMA has organized CPT® codes logically, beginning with classifying them into three types. - CPT® Category I —the largest body of codes consisting of those commonly used by providers to report their services and procedures
- CPT® Category II —supplemental tracking codes used for performance management
- CPT® Category III —temporary codes used to report emerging and experimental services and procedures
Navigating Category I Codes
Most CPT® codes are Category I codes. These represent existing services or procedures widely used and, when appropriate, approved by the Food and Drug Administration (FDA).
|
01000
|
ANESTH-SKIN SURGERY-PELVIS
|
CPT
|
The AMA chose this order because E/M services are the most frequently reported healthcare services. This arrangement, as with resequenced codes, is designed for coding efficiency. The 6 main sections of CPT® Category I codes are
- Evaluation & Management Services (99201 – 99499)
- Anesthesia Services (01000 – 01999)
- Surgery (10021 – 69990) – further broken into body area or system within this code range
- Radiology Services (70010 – 79999)
- Pathology and Laboratory Services (80047 – 89398)
- Medical Services and Procedures (90281 – 99607)
Getting Acquainted with Category II Codes
Category II codes, consisting of four numbers and the letter F, are supplemental tracking and performance measurement codes that providers can assign in addition to Category I codes. Unlike Category I codes, Category II codes are not linked to reimbursement. Providers use Category II codes—which track specific information about their patients, such as whether they use tobacco—to help them deliver better healthcare and achieve better outcomes for their patients.
|
1999
|
ANESTHESIOLOGY GROUP
|
CPT
|
The AMA chose this order because E/M services are the most frequently reported healthcare services. This arrangement, as with resequenced codes, is designed for coding efficiency. The 6 main sections of CPT® Category I codes are
- Evaluation & Management Services (99201 – 99499)
- Anesthesia Services (01000 – 01999)
- Surgery (10021 – 69990) – further broken into body area or system within this code range
- Radiology Services (70010 – 79999)
- Pathology and Laboratory Services (80047 – 89398)
- Medical Services and Procedures (90281 – 99607)
Getting Acquainted with Category II Codes
Category II codes, consisting of four numbers and the letter F, are supplemental tracking and performance measurement codes that providers can assign in addition to Category I codes. Unlike Category I codes, Category II codes are not linked to reimbursement. Providers use Category II codes—which track specific information about their patients, such as whether they use tobacco—to help them deliver better healthcare and achieve better outcomes for their patients.
|
01999
|
Unlisted anesth procedure
|
CPT
|
The AMA chose this order because E/M services are the most frequently reported healthcare services. This arrangement, as with resequenced codes, is designed for coding efficiency. The 6 main sections of CPT® Category I codes are
- Evaluation & Management Services (99201 – 99499)
- Anesthesia Services (01000 – 01999)
- Surgery (10021 – 69990) – further broken into body area or system within this code range
- Radiology Services (70010 – 79999)
- Pathology and Laboratory Services (80047 – 89398)
- Medical Services and Procedures (90281 – 99607)
Getting Acquainted with Category II Codes
Category II codes, consisting of four numbers and the letter F, are supplemental tracking and performance measurement codes that providers can assign in addition to Category I codes. Unlike Category I codes, Category II codes are not linked to reimbursement. Providers use Category II codes—which track specific information about their patients, such as whether they use tobacco—to help them deliver better healthcare and achieve better outcomes for their patients.
|
G0202
|
Scr mammo bi incl cad
|
HCPCS
|
Digital screening mammogram with CAD was performed. Findings: Negative. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam.
|
77052
|
Comp screen mammogram add-on
|
HCPCS
|
Digital screening mammogram with CAD was performed. Findings: Negative. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam.
|
G0202
|
Scr mammo bi incl cad
|
HCPCS
|
CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam. Comparison: Mammogram one year prior. Findings: Bilateral digital implant screening mammogram, standard and displaced views were obtained.
|
77052
|
Comp screen mammogram add-on
|
HCPCS
|
CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.11
Example 2:Patient is a 52-year old female with a personal history of breast cancer, fully resolved status post right breast mastectomy in 1992. She presents for annual digital screening mammogram with CAD. CPT/HCPCS Codes: G0202-52, 77052
ICD-9-CM Codes: V76.11, V10.3
Example 3:History: A 42-year-old female, annual exam. Comparison: Mammogram one year prior. Findings: Bilateral digital implant screening mammogram, standard and displaced views were obtained.
|
G0202
|
Scr mammo bi incl cad
|
HCPCS
|
Bilateral subglandular breast implants are noted. Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters.
|
77052
|
Comp screen mammogram add-on
|
HCPCS
|
Bilateral subglandular breast implants are noted. Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters.
|
G0202
|
Scr mammo bi incl cad
|
HCPCS
|
Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active.
|
77052
|
Comp screen mammogram add-on
|
HCPCS
|
Implants appear stable and mammographically intact. CPT/HCPCS Codes: G0202, 77052
ICD-9-CM Codes: V76.12
Aimee Wilcox, MA, CST, CCS-P is a Certified Coding Guru (CCG) for Find-A-Code. For more information about ICD-10-CM, ICD-10-PCS, and medical coding and billing please visit FindACode.com where you will find the ICD-10 code sets and the current ICD-9-CM, CPT, and HCPCS code sets plus a wealth of additional information related to medical billing and coding. This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
The Healthcare Common Procedure Coding System (HCPCS) is a two-tiered system that includes Common Procedure Terminology, at Level I, which is usually referred to as CPT codes. More specialized codes are used for reporting services to Medicare and other payers at Level II. Since these codes do not have an equivalent in any other manual but the Center for Medicare and Medicaid Services HCPCS manual, these codes are referred to as HCPCS in the field, to differentiate them from the more universal CPT codes. The use of HCPCS for all medical transactions was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPPA). While HIPPA established a number of regulations governing the transmission of Protected Health Information (PHI), its enactment also mandated the use of the same codes across the industry to describe medical procedures.
|
1996
|
Daily Hospital Management Of Epidural Or Subarachnoid Continuous Drug Administration
|
HCPCS
|
More specialized codes are used for reporting services to Medicare and other payers at Level II. Since these codes do not have an equivalent in any other manual but the Center for Medicare and Medicaid Services HCPCS manual, these codes are referred to as HCPCS in the field, to differentiate them from the more universal CPT codes. The use of HCPCS for all medical transactions was mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPPA). While HIPPA established a number of regulations governing the transmission of Protected Health Information (PHI), its enactment also mandated the use of the same codes across the industry to describe medical procedures. For this reason, both medical billers and medical coders need a solid understanding of how these codes are meant to be used, the kind of understanding that can only be gained through a formal education program of study.
|
E0483
|
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
|
HCPCS
|
In a 2007 cross-over study with 36 patients, Eaton and colleagues compared the Flutter device, the active cycle of breathing technique and active cycle of breathing plus postural drainage, inrandom order. (10) Total sputum weight was highest after active cycle of breathing plus posturaldrainage; patient preference was highest for use of the Flutter device. In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services.
|
E0481
|
Intrpulmnry percuss vent sys
|
HCPCS
|
In a 2007 cross-over study with 36 patients, Eaton and colleagues compared the Flutter device, the active cycle of breathing technique and active cycle of breathing plus postural drainage, inrandom order. (10) Total sputum weight was highest after active cycle of breathing plus posturaldrainage; patient preference was highest for use of the Flutter device. In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services.
|
A7025
|
VEST PTNT THE VEST WRP TPY SYS 2XL DISP
|
HCPCS
|
In a 2007 cross-over study with 36 patients, Eaton and colleagues compared the Flutter device, the active cycle of breathing technique and active cycle of breathing plus postural drainage, inrandom order. (10) Total sputum weight was highest after active cycle of breathing plus posturaldrainage; patient preference was highest for use of the Flutter device. In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services.
|
E0484
|
Oscillatory positive expiratory pressure device, non-electric, any type, each
|
HCPCS
|
In a 2007 cross-over study with 36 patients, Eaton and colleagues compared the Flutter device, the active cycle of breathing technique and active cycle of breathing plus postural drainage, inrandom order. (10) Total sputum weight was highest after active cycle of breathing plus posturaldrainage; patient preference was highest for use of the Flutter device. In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services.
|
A7026
|
Replace chst cmprss sys hose
|
HCPCS
|
In a 2007 cross-over study with 36 patients, Eaton and colleagues compared the Flutter device, the active cycle of breathing technique and active cycle of breathing plus postural drainage, inrandom order. (10) Total sputum weight was highest after active cycle of breathing plus posturaldrainage; patient preference was highest for use of the Flutter device. In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services.
|
E0483
|
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
|
HCPCS
|
In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged.
|
E0481
|
Intrpulmnry percuss vent sys
|
HCPCS
|
In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged.
|
A7025
|
VEST PTNT THE VEST WRP TPY SYS 2XL DISP
|
HCPCS
|
In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged.
|
E0484
|
Oscillatory positive expiratory pressure device, non-electric, any type, each
|
HCPCS
|
In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged.
|
A7026
|
Replace chst cmprss sys hose
|
HCPCS
|
In a study of 20 patients with acuteexacerbation of bronchiectasis during antibiotic therapy, Patterson et al. found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged.
|
E0483
|
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
|
HCPCS
|
found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added.
|
E0481
|
Intrpulmnry percuss vent sys
|
HCPCS
|
found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added.
|
A7025
|
VEST PTNT THE VEST WRP TPY SYS 2XL DISP
|
HCPCS
|
found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added.
|
E0484
|
Oscillatory positive expiratory pressure device, non-electric, any type, each
|
HCPCS
|
found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added.
|
A7026
|
Replace chst cmprss sys hose
|
HCPCS
|
found no difference in changes inlung function with the “usual” airway clearance approach compared to Acapella. (11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added.
|
E0483
|
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each
|
HCPCS
|
(11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added. Clinical input reviewed.
|
E0481
|
Intrpulmnry percuss vent sys
|
HCPCS
|
(11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added. Clinical input reviewed.
|
A7025
|
VEST PTNT THE VEST WRP TPY SYS 2XL DISP
|
HCPCS
|
(11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added. Clinical input reviewed.
|
E0484
|
Oscillatory positive expiratory pressure device, non-electric, any type, each
|
HCPCS
|
(11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added. Clinical input reviewed.
|
A7026
|
Replace chst cmprss sys hose
|
HCPCS
|
(11)
Chronic Obstructive Pulmonary Disease (COPD)
Ongoing clinical trials
Clinical Input Received Through Physician Specialty Societies and Academic Medical Centers
In April 2009, the Cystic Fibrosis Foundation published guidelines on airway clearance therapies based
Medicare National Coverage
|ICD-9 Procedure||93.18||Breathing exercise|
|ICD-9 Diagnosis||277.00-277.09||Cystic Fibrosis NOS|
|494.0, 494.1||Bronchiectasis without and with acute exacerbations, respectively|
|HCPCS||E0483||High frequency chest wall oscillation air-pulse generator system (includes hoses and vest), each|
|A7025||High frequency chest wall oscillation system vest, replacement for use with patient-owned equipment, each|
|A7026||High frequency chest wall oscillation system hose, replacement for use with patient-owned equipment, each|
|E0481||Intrapulmonary percussive ventilation system and related accessories|
|E0484||Oscillatory positive expiratory pressure device, non-electric, any type|
|ICD-10-CM (effective 10/1/14)||E84.0-E84.9||Cystic fibrosis code range|
|J47.1-J47.9||Broncheictasis code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no ICD-10-PCS codes for devices and there is no is no specific ICD-10-PCS code for this therapy.|
|F07C6ZZ||Physical rehabilitation and diagnostic audiology, rehabilitation, motor treatment, respiratory system- whole body, therapeutic exercise|
|Type of Service||Pulmonary|
|Place of Service||Home|
Cystic Fibrosis, Oscillatory Devices
High Frequency Chest Compression
Intrapulmonary Percussive Ventilation (IPV)
IPV (Intrapulmonary Percussive Ventilation)
Oscillatory Devices for Cystic Fibrosis
|11/01/97||Add to DME Section||New policy|
|07/12/02||Replace policy||Policy reviewed and updated, no change in policy statement|
|10/09/03||Replace policy||Literature review updated, expanded policy title, Medicare policy and new HCPCS codes added; policy statement unchanged|
|04/16/04||Replace policy||Policy updated with literature review. Acapella device added (similar to Flutter device); no change in policy statement|
|4/1/05||Replace policy||Policy updated with literature review; no changes in policy statement.|
|10/10/2006||Replace policy||Policy updated with literature review through August 2006; policy statement unchanged. References 14-16 added and reference 17 is renumbered.|
|12/11/08||Replace policy||Policy updated with literature review; reference numbers 17 – 21 added. Clinical input reviewed.
|
1000
|
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
|
RC
|
The ICD-10 codes are applicable for hospital inpatient procedures. ICD-10-PCS (Procedure Coding System), designed by 3M Health Information Management for Centers of Medicare and Medicaid, is the code set to replace the Volume 3 of ICD-9-CM for inpatient procedure reporting. This ICD-10-PCS has approx. 71000 alpha-numeric codes which has seven digits. Structure of ICD-10-PCS Codes:
In the structure,
For the example shown above, ICD-10 code for knee joint replacement (0SRC0JZ – Replacement of Right Knee Joint with Synthetic Substitute, Open Approach) means the following:
For more information on ICD-10-PCD codes, click here: http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/08_ICD10.asp
Moving to ICD-10 will speed up the medical reimbursement process in the industry and reduce the payment errors.
|
1000
|
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
|
RC
|
ICD-10-PCS (Procedure Coding System), designed by 3M Health Information Management for Centers of Medicare and Medicaid, is the code set to replace the Volume 3 of ICD-9-CM for inpatient procedure reporting. This ICD-10-PCS has approx. 71000 alpha-numeric codes which has seven digits. Structure of ICD-10-PCS Codes:
In the structure,
For the example shown above, ICD-10 code for knee joint replacement (0SRC0JZ – Replacement of Right Knee Joint with Synthetic Substitute, Open Approach) means the following:
For more information on ICD-10-PCD codes, click here: http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/08_ICD10.asp
Moving to ICD-10 will speed up the medical reimbursement process in the industry and reduce the payment errors. It also enhances the quality of healthcare offered to patients.
|
1000
|
HC ASAM LEVEL 3.7 MEDICALLY MONITORED INPATIENT
|
RC
|
This ICD-10-PCS has approx. 71000 alpha-numeric codes which has seven digits. Structure of ICD-10-PCS Codes:
In the structure,
For the example shown above, ICD-10 code for knee joint replacement (0SRC0JZ – Replacement of Right Knee Joint with Synthetic Substitute, Open Approach) means the following:
For more information on ICD-10-PCD codes, click here: http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/08_ICD10.asp
Moving to ICD-10 will speed up the medical reimbursement process in the industry and reduce the payment errors. It also enhances the quality of healthcare offered to patients. The Department of Health & Human Services (HHS) published the final rules for adoption of new HIPAA standards on January 16, 2009.
|
90838
|
Psytx w pt w e/m 60 min
|
HCPCS
|
As tinnitus-retraining therapy in part involves counseling, an individual psychotherapy CPT code may be used (code range 90832–90838). Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy.
|
97026
|
PR APPLICATION MODALITY 1/> AREAS INFRARED
|
HCPCS
|
As tinnitus-retraining therapy in part involves counseling, an individual psychotherapy CPT code may be used (code range 90832–90838). Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy.
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
As tinnitus-retraining therapy in part involves counseling, an individual psychotherapy CPT code may be used (code range 90832–90838). Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy.
|
90832
|
Psytx w pt 30 minutes
|
HCPCS
|
As tinnitus-retraining therapy in part involves counseling, an individual psychotherapy CPT code may be used (code range 90832–90838). Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy.
|
97026
|
PR APPLICATION MODALITY 1/> AREAS INFRARED
|
HCPCS
|
Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation).
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation).
|
E0720
|
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
|
HCPCS
|
Tinnitus-retraining therapy may also be billed as physical or speech therapy. There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation).
|
97026
|
PR APPLICATION MODALITY 1/> AREAS INFRARED
|
HCPCS
|
There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment.
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment.
|
E0720
|
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
|
HCPCS
|
There is no specific CPT code for low-level laser therapy. However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment.
|
97026
|
PR APPLICATION MODALITY 1/> AREAS INFRARED
|
HCPCS
|
However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices.
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices.
|
E0720
|
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
|
HCPCS
|
However, providers may elect to use CPT code 97026 (application of a modality; infrared), since the laser emits light in the infrared spectrum. In January 2004, a HCPCS code (S8948) was added that is specific to low-level laser therapy. As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices.
|
E0720
|
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation
|
HCPCS
|
As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices. There is a specific CPT code for tinnitus assessment –
92625: Assessment of tinnitus (includes pitch, loudness matching, and masking)
BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices, drugs or biologics may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. Since tinnitus is a subjective symptom without a known physiologic explanation, randomized placebo-controlled trials are particularly important to validate the effectiveness of any treatment compared to the expected placebo effect.
|
92625
|
Tinnitus assessment
|
HCPCS
|
As described in the literature, electrical stimulation is an office-based procedure, but if self-administered by the patient, the device could possibly be described by HCPCS code E0720 (transcutaneous electrical nerve stimulation [TENS] device, 2 lead, localized stimulation). Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices. There is a specific CPT code for tinnitus assessment –
92625: Assessment of tinnitus (includes pitch, loudness matching, and masking)
BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices, drugs or biologics may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. Since tinnitus is a subjective symptom without a known physiologic explanation, randomized placebo-controlled trials are particularly important to validate the effectiveness of any treatment compared to the expected placebo effect.
|
92625
|
Tinnitus assessment
|
HCPCS
|
Tinnitus-masking devices represent a piece of durable medical equipment. There is currently no specific HCPCS code describing these devices. There is a specific CPT code for tinnitus assessment –
92625: Assessment of tinnitus (includes pitch, loudness matching, and masking)
BlueCard/National Account Issues
State or federal mandates (e.g., FEP) may dictate that all FDA-approved devices, drugs or biologics may not be considered investigational and thus these devices may be assessed only on the basis of their medical necessity. Since tinnitus is a subjective symptom without a known physiologic explanation, randomized placebo-controlled trials are particularly important to validate the effectiveness of any treatment compared to the expected placebo effect. This literature review was updated through April 18, 2013.
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
- Stidham KR, Solomon PH, Roberson JB. Evaluation of botulinum toxin A in treatment of tinnitus. Otolaryngol Head Neck Surg 2005; 132(6):883-9. |CPT||No specific CPT codes; see Policy Guidelines|
|ICD-9 Diagnosis||Investigational for all relevant diagnoses|
|HCPCS||S8948||Application of a modality (requiring constant provider attendance) to one or more areas; low level laser; each 15 minutes|
|ICD-10-CM (effective 10/1/14)||Investigational for all relevant diagnoses|
|H93.11-H93.19||Tinnitus code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no specific ICD-10-PCS codes for these procedures.|
|Type of Service||Medicine|
|Place of Service||Physician’s Office|
Masking Device, Tinnitus
Tinnitus, Treatment of
|08/15/01||Add to Therapy section||New policy|
|12/30/02||Replace policy||Literature review update; transmeatal irradiation added; no change in policy statement|
|04/29/03||Replace policy||Policy updated with literature search extending from January 2001 to December 2002; policy statement unchanged|
|03/15/05||Replace policy||Literature review updated for the period of December 2002 through December 2004; references added.
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
Evaluation of botulinum toxin A in treatment of tinnitus. Otolaryngol Head Neck Surg 2005; 132(6):883-9. |CPT||No specific CPT codes; see Policy Guidelines|
|ICD-9 Diagnosis||Investigational for all relevant diagnoses|
|HCPCS||S8948||Application of a modality (requiring constant provider attendance) to one or more areas; low level laser; each 15 minutes|
|ICD-10-CM (effective 10/1/14)||Investigational for all relevant diagnoses|
|H93.11-H93.19||Tinnitus code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no specific ICD-10-PCS codes for these procedures.|
|Type of Service||Medicine|
|Place of Service||Physician’s Office|
Masking Device, Tinnitus
Tinnitus, Treatment of
|08/15/01||Add to Therapy section||New policy|
|12/30/02||Replace policy||Literature review update; transmeatal irradiation added; no change in policy statement|
|04/29/03||Replace policy||Policy updated with literature search extending from January 2001 to December 2002; policy statement unchanged|
|03/15/05||Replace policy||Literature review updated for the period of December 2002 through December 2004; references added. Added electromagnetic energy to the investigational policy statement|
|04/25/06||Replace policy||Literature review updated for the period of December 2004 through March 2006; transcranial magnetic stimulation and botulinum toxin A injections added to the investigational policy statement|
|02/14/08||Replace policy||Policy updated with literature search; references 17-20 added; policy statement unchanged|
|04/24/09||Replace policy||Policy updated with literature search through March 2009; references added and reordered; policy statement unchanged|
|05/13/10||Replace policy||Policy updated with literature search through April 2010; references added and reordered; policy statement unchanged|
|5/12/11||Replace policy||Policy updated with literature search through March 2011; references added and reordered; policy statement unchanged|
|5/10/12||Replace policy||Policy updated with literature search through March 2012; references added and reordered; some references removed; policy statement unchanged|
|5/09/13||Replace policy||Policy updated with literature search through April 18, 2013; references 1, 7, 24, and 29 added and references reordered; policy statement unchanged|
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
Otolaryngol Head Neck Surg 2005; 132(6):883-9. |CPT||No specific CPT codes; see Policy Guidelines|
|ICD-9 Diagnosis||Investigational for all relevant diagnoses|
|HCPCS||S8948||Application of a modality (requiring constant provider attendance) to one or more areas; low level laser; each 15 minutes|
|ICD-10-CM (effective 10/1/14)||Investigational for all relevant diagnoses|
|H93.11-H93.19||Tinnitus code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no specific ICD-10-PCS codes for these procedures.|
|Type of Service||Medicine|
|Place of Service||Physician’s Office|
Masking Device, Tinnitus
Tinnitus, Treatment of
|08/15/01||Add to Therapy section||New policy|
|12/30/02||Replace policy||Literature review update; transmeatal irradiation added; no change in policy statement|
|04/29/03||Replace policy||Policy updated with literature search extending from January 2001 to December 2002; policy statement unchanged|
|03/15/05||Replace policy||Literature review updated for the period of December 2002 through December 2004; references added. Added electromagnetic energy to the investigational policy statement|
|04/25/06||Replace policy||Literature review updated for the period of December 2004 through March 2006; transcranial magnetic stimulation and botulinum toxin A injections added to the investigational policy statement|
|02/14/08||Replace policy||Policy updated with literature search; references 17-20 added; policy statement unchanged|
|04/24/09||Replace policy||Policy updated with literature search through March 2009; references added and reordered; policy statement unchanged|
|05/13/10||Replace policy||Policy updated with literature search through April 2010; references added and reordered; policy statement unchanged|
|5/12/11||Replace policy||Policy updated with literature search through March 2011; references added and reordered; policy statement unchanged|
|5/10/12||Replace policy||Policy updated with literature search through March 2012; references added and reordered; some references removed; policy statement unchanged|
|5/09/13||Replace policy||Policy updated with literature search through April 18, 2013; references 1, 7, 24, and 29 added and references reordered; policy statement unchanged|
|
S8948
|
Low-level laser trmt 15 min
|
HCPCS
|
|CPT||No specific CPT codes; see Policy Guidelines|
|ICD-9 Diagnosis||Investigational for all relevant diagnoses|
|HCPCS||S8948||Application of a modality (requiring constant provider attendance) to one or more areas; low level laser; each 15 minutes|
|ICD-10-CM (effective 10/1/14)||Investigational for all relevant diagnoses|
|H93.11-H93.19||Tinnitus code range|
|ICD-10-PCS (effective 10/1/14)||ICD-10-PCS codes are only used for inpatient services. There are no specific ICD-10-PCS codes for these procedures.|
|Type of Service||Medicine|
|Place of Service||Physician’s Office|
Masking Device, Tinnitus
Tinnitus, Treatment of
|08/15/01||Add to Therapy section||New policy|
|12/30/02||Replace policy||Literature review update; transmeatal irradiation added; no change in policy statement|
|04/29/03||Replace policy||Policy updated with literature search extending from January 2001 to December 2002; policy statement unchanged|
|03/15/05||Replace policy||Literature review updated for the period of December 2002 through December 2004; references added. Added electromagnetic energy to the investigational policy statement|
|04/25/06||Replace policy||Literature review updated for the period of December 2004 through March 2006; transcranial magnetic stimulation and botulinum toxin A injections added to the investigational policy statement|
|02/14/08||Replace policy||Policy updated with literature search; references 17-20 added; policy statement unchanged|
|04/24/09||Replace policy||Policy updated with literature search through March 2009; references added and reordered; policy statement unchanged|
|05/13/10||Replace policy||Policy updated with literature search through April 2010; references added and reordered; policy statement unchanged|
|5/12/11||Replace policy||Policy updated with literature search through March 2011; references added and reordered; policy statement unchanged|
|5/10/12||Replace policy||Policy updated with literature search through March 2012; references added and reordered; some references removed; policy statement unchanged|
|5/09/13||Replace policy||Policy updated with literature search through April 18, 2013; references 1, 7, 24, and 29 added and references reordered; policy statement unchanged|
|
0264
|
IV Therapy - IV Therapy/Supplies
|
RC
|
Lauren took her acetaminophen orally so the concept ID 4132161 (“Oral”) is used.|
|LOT_NUMBER||NULL||An identifier assigned to a particular quantity or lot of Drug product from the manufacturer. This information is rarely captured.|
|PROVIDER_ID||NULL||If the drug record has a prescribing Provider listed, the ID for that Provider goes in this field. In that case this contains the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||509||A foreign key to the VISIT_OCCURRENCE table during which the Drug was prescribed.|
|VISIT_DETAIL_ID||NULL||A foreign key to the VISIT_DETAIL table during which the Drug was prescribed.|
|DRUG_SOURCE_ VALUE||69842087651||This is the source code for the Drug as it appears in the source data. In Lauren’s case the NDC code is stored here.|
|DRUG_SOURCE_ CONCEPT_ID||750264||This is the Concept that represents the drug source value. The Concept 750264 standing for the NDC code for “Acetaminophen 325 MG Oral Tablet”.|
|ROUTE_SOURCE_ VALUE||NULL||The verbatim information about the route of administration as detailed in the source.|
The PROCEDURE_OCCURRENCE table contains records of activities or processes ordered or carried out by a healthcare Provider on the patient with a diagnostic or therapeutic purpose.
|
0264
|
IV Therapy - IV Therapy/Supplies
|
RC
|
In that case this contains the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||509||A foreign key to the VISIT_OCCURRENCE table during which the Drug was prescribed.|
|VISIT_DETAIL_ID||NULL||A foreign key to the VISIT_DETAIL table during which the Drug was prescribed.|
|DRUG_SOURCE_ VALUE||69842087651||This is the source code for the Drug as it appears in the source data. In Lauren’s case the NDC code is stored here.|
|DRUG_SOURCE_ CONCEPT_ID||750264||This is the Concept that represents the drug source value. The Concept 750264 standing for the NDC code for “Acetaminophen 325 MG Oral Tablet”.|
|ROUTE_SOURCE_ VALUE||NULL||The verbatim information about the route of administration as detailed in the source.|
The PROCEDURE_OCCURRENCE table contains records of activities or processes ordered or carried out by a healthcare Provider on the patient with a diagnostic or therapeutic purpose. Procedures are present in various data sources in different forms with varying levels of standardization. For example:
- Medical Claims include procedure codes that are submitted as part of a claim for health services rendered, including procedures performed.
|
0443
|
Speech-language Pathology - Group
|
RC
|
does it come from an insurance claim, EHR order, etc. For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.|
|MODIFIER_CONCEPT_ ID||0||This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.|
|QUANTITY||0||The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.|
|PROVIDER_ID||NULL||If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||740||If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.|
|VISIT_DETAIL_ID||NULL||If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.|
|PROCEDURE_SOURCE_ VALUE||304435002||The code or information for the Procedure as it appears in the source data.|
|PROCEDURE_SOURCE_ CONCEPT_ID||4127451||This is the Concept that represents the procedure source value.|
|MODIFIER_SOURCE_ VALUE||NULL||The source code for the modifier as it appears in the source data.|
4.4 Additional Information
This chapter covers only a portion of the tables available in the CDM as examples of how data is represented.
|
4127
|
CATH SWN/GZ VIP 5FR 110CM
|
CDM
|
does it come from an insurance claim, EHR order, etc. For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.|
|MODIFIER_CONCEPT_ ID||0||This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.|
|QUANTITY||0||The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.|
|PROVIDER_ID||NULL||If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||740||If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.|
|VISIT_DETAIL_ID||NULL||If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.|
|PROCEDURE_SOURCE_ VALUE||304435002||The code or information for the Procedure as it appears in the source data.|
|PROCEDURE_SOURCE_ CONCEPT_ID||4127451||This is the Concept that represents the procedure source value.|
|MODIFIER_SOURCE_ VALUE||NULL||The source code for the modifier as it appears in the source data.|
4.4 Additional Information
This chapter covers only a portion of the tables available in the CDM as examples of how data is represented.
|
0275
|
PACEMAKER, SINGLE CHAMBER, RATE-RESPONSIVE (IMPLANTABLE)
|
RC
|
does it come from an insurance claim, EHR order, etc. For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.|
|MODIFIER_CONCEPT_ ID||0||This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.|
|QUANTITY||0||The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.|
|PROVIDER_ID||NULL||If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||740||If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.|
|VISIT_DETAIL_ID||NULL||If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.|
|PROCEDURE_SOURCE_ VALUE||304435002||The code or information for the Procedure as it appears in the source data.|
|PROCEDURE_SOURCE_ CONCEPT_ID||4127451||This is the Concept that represents the procedure source value.|
|MODIFIER_SOURCE_ VALUE||NULL||The source code for the modifier as it appears in the source data.|
4.4 Additional Information
This chapter covers only a portion of the tables available in the CDM as examples of how data is represented.
|
0443
|
Speech-language Pathology - Group
|
RC
|
For this example the concept ID 38000275 (“EHR order list entry”) is used as the procedure record is from an EHR record.|
|MODIFIER_CONCEPT_ ID||0||This is meant for a concept ID representing the modifier on the procedure. For example, if the record indicated that a CPT4 procedure was performed bilaterally then the concept ID 42739579 (“Bilateral procedure”) would be used.|
|QUANTITY||0||The quantity of Procedures ordered or administered. A missing Quantity, the numbers 0 and 1 all mean the same thing.|
|PROVIDER_ID||NULL||If the Procedure record has a Provider listed, the ID for that Provider goes in this field. This should be a foreign key to the PROVIDER_ID from the PROVIDER table.|
|VISIT_OCCURRENCE_ ID||740||If known, this is the Visit (represented as VISIT_occurrence_id taken from the VISIT_OCCURRENCE table) during which the procedure was performed.|
|VISIT_DETAIL_ID||NULL||If known, this is the Visit detail (represented as VISIT_detail_id taken from the VISIT_DETAIL table) during which the procedure was performed.|
|PROCEDURE_SOURCE_ VALUE||304435002||The code or information for the Procedure as it appears in the source data.|
|PROCEDURE_SOURCE_ CONCEPT_ID||4127451||This is the Concept that represents the procedure source value.|
|MODIFIER_SOURCE_ VALUE||NULL||The source code for the modifier as it appears in the source data.|
4.4 Additional Information
This chapter covers only a portion of the tables available in the CDM as examples of how data is represented. You are encouraged to visit the wiki site19 for more information.
|
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