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CPT codes for Acupuncture Detoxification

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Tifsmom1:
Are there CPT codes for this and are they billable to insurance and Medicaid? The only acupunture codes i am finding are medical and not billable either because they are not in our contract or to Colorado Medicaid.

PMRNC:

--- Quote ---Are there CPT codes for this and are they billable to insurance and Medicaid? The only acupunture codes i am finding are medical and not billable either because they are not in our contract or to Colorado Medicaid.

--- End quote ---

Procedure codes would be same: 97810-97814, your diagnosis codes will vary, I don't think any insurance would pay for acupuncture for detox, but I could be wrong, I know most carriers only pay it for chronic pain and only if administered by licensed provider within scope of the license for that state. Again, I could be wrong, wouldn't be the first time Medicaid paid for things other working people can't get coverage for.  :-[ :o

Christy:
Yes, the cpt codes are 97810-97814. More and more carriers are covering acupuncture, even some managed Medicaids in NYS. Medicare and NY straight Medicaid, do not cover, however.

There needs to be a diagnosis code, which should be the condition that the patient is detoxing from....i.e. headache, joint pain, etc....

PMRNC:

--- Quote ---Yes, the cpt codes are 97810-97814. More and more carriers are covering acupuncture, even some managed Medicaids in NYS. Medicare and NY straight Medicaid, do not cover, however.
--- End quote ---

Not for Detox.. chronic pain.. yes.. i'm in NYS also



--- Quote ---There needs to be a diagnosis code, which should be the condition that the patient is detoxing from....i.e. headache, joint pain, etc....

--- End quote ---

Agree, but the detox is from a substance.. would NOT be headache, joint pain, etc..those would be the diagnosis codes. In many cases the carrier will pay for diagnosis realated to chronic pain.. NOT detoxification..but like I said prior.. I could be wrong. best to check with carrier.

Christy:
almost all of the carriers in NYS have dropped the requirement of a pain/nausea dx. But yes, benefits must ALWAYS be verified with the carrier. In the case of detox from alcohol or drugs, if that's what the OP meant, if there is a valid DX code that's covered, it is payable. I don't know much about addiction, but say if the person is experiencing nausea as part of the detox, that is a valid dx.

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