How To Use CPT Code 0513T

CPT 0513T describes the use of extracorporeal shock wave therapy for integumentary wound healing, including topical application and dressing care, for each additional wound. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0513T?

CPT 0513T can be used to describe the application of shock waves to promote healing and reduce pain of an additional skin wound after treating an initial wound at the same session. This code includes the topical application of medicinal ointments and wound dressings.

2. Official Description

The official description of CPT code 0513T is: ‘Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 0512T for the treatment of the initial wound.

3. Procedure

1. During the same session as the treatment of the initial wound, the healthcare provider applies a water-based conductive gel or a water cushion to conduct sound waves over the area of an additional wound.
2. The provider then places the head of the therapy unit over the affected area and delivers sound waves through it.
3. The goal of this procedure is to stimulate healing of the wound tissues.
4. At the completion of the procedure, the provider applies a topical ointment and a dressing over the wound.
5. One unit of CPT code 0513T represents the treatment of a single additional integumentary wound after the treatment of the first wound at an encounter.

4. Qualifying circumstances

CPT 0513T is used when there is a need to treat an additional integumentary wound after the treatment of the initial wound at the same session. The provider must apply shock waves to promote healing and reduce pain of the additional wound. This code is specifically for integumentary wounds and should not be used for other types of wounds or conditions.

5. When to use CPT code 0513T

CPT code 0513T should be used when the provider is treating an additional integumentary wound after the treatment of the first wound at the same session. It is important to note that this code is an add-on code, so it should be reported with an appropriate primary code, such as CPT code 0512T for the treatment of the initial wound.

6. Documentation requirements

To support a claim for CPT code 0513T, the healthcare provider must document the following information:

• Identification of the initial wound that was treated
• Description of the additional integumentary wound that is being treated
• Details of the shock wave therapy procedure, including the use of conductive gel or water cushion, delivery of sound waves, and application of topical ointment and dressing
• Date and duration of the procedure
• Signature of the healthcare provider performing the service

7. Billing guidelines

When billing for CPT code 0513T, ensure that the provider has already treated the initial wound at the same session. This code should be listed separately in addition to the code for the primary procedure (CPT code 0512T). It is important to note that payers may not reimburse for CPT code 0513T unless it is reported with the appropriate primary code. Therefore, it is crucial to follow the billing guidelines and report both codes together.

8. Historical information

CPT code 0513T was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition. It is important to stay updated with any changes or revisions to ensure accurate coding and billing.

9. Examples

1. A healthcare provider treats an initial wound on a patient’s leg using extracorporeal shock wave therapy (CPT code 0512T). During the same session, the provider identifies an additional wound on the patient’s arm and applies shock waves to promote healing and reduce pain (CPT code 0513T).
2. After treating an initial wound on a patient’s back using extracorporeal shock wave therapy (CPT code 0512T), a provider discovers an additional wound on the patient’s shoulder and proceeds to apply shock waves for healing and pain reduction (CPT code 0513T).
3. During a session, a healthcare provider treats an initial wound on a patient’s foot using extracorporeal shock wave therapy (CPT code 0512T). The provider then identifies an additional wound on the patient’s ankle and applies shock waves to facilitate healing and alleviate pain (CPT code 0513T).
4. After treating an initial wound on a patient’s hand using extracorporeal shock wave therapy (CPT code 0512T), a provider discovers an additional wound on the patient’s finger and proceeds to apply shock waves for wound healing and pain reduction (CPT code 0513T).
5. A healthcare provider performs extracorporeal shock wave therapy (CPT code 0512T) to treat an initial wound on a patient’s abdomen. During the same session, the provider identifies an additional wound on the patient’s thigh and applies shock waves to promote healing and reduce pain (CPT code 0513T).
6. After treating an initial wound on a patient’s arm using extracorporeal shock wave therapy (CPT code 0512T), a provider discovers an additional wound on the patient’s chest and proceeds to apply shock waves for wound healing and pain reduction (CPT code 0513T).
7. During a session, a healthcare provider treats an initial wound on a patient’s leg using extracorporeal shock wave therapy (CPT code 0512T). The provider then identifies an additional wound on the patient’s back and applies shock waves to facilitate healing and alleviate pain (CPT code 0513T).
8. After treating an initial wound on a patient’s shoulder using extracorporeal shock wave therapy (CPT code 0512T), a provider discovers an additional wound on the patient’s arm and proceeds to apply shock waves for wound healing and pain reduction (CPT code 0513T).
9. A healthcare provider performs extracorporeal shock wave therapy (CPT code 0512T) to treat an initial wound on a patient’s thigh. During the same session, the provider identifies an additional wound on the patient’s abdomen and applies shock waves to promote healing and reduce pain (CPT code 0513T).
10. After treating an initial wound on a patient’s back using extracorporeal shock wave therapy (CPT code 0512T), a provider discovers an additional wound on the patient’s leg and proceeds to apply shock waves for wound healing and pain reduction (CPT code 0513T).