How To Use CPT Code 20974

CPT 20974 describes the noninvasive procedure of electrical stimulation to aid bone healing. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 20974?

CPT 20974 is a code used to describe the noninvasive procedure of electrical stimulation to aid bone healing. This procedure involves the placement of a device that emits electrical impulses at the site of a broken bone to promote the healing process. The electrical stimulation device is worn on or attached to the outside of the body, and electrodes are applied to the skin at the fracture site to deliver the electrical impulses.

2. Official Description

The official description of CPT code 20974 is: ‘Electrical stimulation to aid bone healing noninvasive (nonoperative).’ This code specifically refers to the application of electrical stimulation for bone healing without the need for surgery.

3. Procedure

The procedure for CPT 20974 involves the following steps:

1. The healthcare provider assesses the patient’s condition and determines the need for electrical stimulation to aid bone healing.
2. The provider fits the patient with an electrical stimulation device that is worn on or attached to the outside of the body.
3. The provider applies electrodes on the skin at the site of the fracture, through which the electrical impulses travel.
4. The provider sets the controls on the device to administer electrical stimulation at the appropriate rate to promote bone healing.

4. Qualifying circumstances

CPT 20974 is typically used for patients who have experienced a broken bone and require noninvasive treatment to aid in the healing process. This procedure is commonly used for nonunion, which is the failure of a broken bone to heal, involving long bones primarily in the extremities. It may also be used as an adjunct to spinal fusion surgery for patients at high risk of pseudoarthrosis, which is the failure of a surgically fused joint to solidify. The procedure is typically performed by a healthcare provider who is trained in the application of electrical stimulation devices.

5. When to use CPT code 20974

CPT code 20974 should be used when a healthcare provider applies electrical stimulation to aid bone healing in a noninvasive manner. This code is appropriate for cases where the patient has a broken bone that requires nonoperative treatment and the provider applies the electrical stimulation device directly. It is important to note that if the application of the device is performed by the manufacturer’s representative, CPT code 20974 should not be reported.

6. Documentation requirements

To support a claim for CPT 20974, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for electrical stimulation to aid bone healing
• Details of the electrical stimulation device used
• Date of the procedure
• Location of the fracture site
• Duration of the electrical stimulation
• Progress made by the patient in terms of bone healing
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 20974, it is important to ensure that the procedure meets the criteria for noninvasive electrical stimulation to aid bone healing. The healthcare provider should apply the electrical stimulation device directly, and the procedure should be documented appropriately. It is also important to note that CPT code 20974 should not be reported if the application of the device is performed by the manufacturer’s representative.

8. Historical information

CPT code 20974 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 20974

There are several similar codes to CPT 20974 that are used to describe related procedures. These include:

• CPT 20979: This code is used for low intensity ultrasound stimulation to aid bone healing in a noninvasive, nonoperative manner.
• CPT 20975: This code is used for the application of an electrical bone stimulator with a pulsed electromagnetic field device.
• CPT 20976: This code is used for the application of an electrical bone stimulator with a capacitive coupling device.
• CPT 20977: This code is used for the application of an electrical bone stimulator with a combined magnetic field device.
• CPT 20978: This code is used for the application of an electrical bone stimulator with a combined magnetic field and pulsed electromagnetic field device.

9. Examples

1. A patient with a nonunion fracture in their leg receives noninvasive electrical stimulation to aid bone healing using CPT code 20974.
2. A patient undergoes spinal fusion surgery and requires adjunctive electrical stimulation to aid bone healing. CPT code 20974 is used for the noninvasive application of the electrical stimulation device.
3. A healthcare provider applies electrical stimulation to aid bone healing for a patient with a failed joint fusion. CPT code 20974 is used for the noninvasive procedure.
4. A patient with a broken arm receives noninvasive electrical stimulation to aid bone healing using CPT code 20974.
5. A healthcare provider applies electrical stimulation to aid bone healing for a patient with a nonunion fracture in their foot. CPT code 20974 is used for the noninvasive procedure.
6. A patient with a failed spinal fusion undergoes adjunctive electrical stimulation to aid bone healing. CPT code 20974 is used for the noninvasive application of the electrical stimulation device.
7. A healthcare provider applies electrical stimulation to aid bone healing for a patient with a nonunion fracture in their hand. CPT code 20974 is used for the noninvasive procedure.
8. A patient with a failed joint fusion receives noninvasive electrical stimulation to aid bone healing using CPT code 20974.
9. A healthcare provider applies electrical stimulation to aid bone healing for a patient with a nonunion fracture in their shoulder. CPT code 20974 is used for the noninvasive procedure.
10. A patient with a failed spinal fusion undergoes adjunctive electrical stimulation to aid bone healing. CPT code 20974 is used for the noninvasive application of the electrical stimulation device.