How To Use CPT Code 97810

CPT 97810 is a code used for acupuncture procedures without electrical stimulation during the initial 15 minutes of personal one-on-one contact with the patient. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 97810.

1. What is CPT 97810?

CPT 97810 is a medical billing code used to describe acupuncture procedures that involve the use of one or more needles without electrical stimulation during the initial 15 minutes of personal one-on-one contact with the patient. This code is used by healthcare providers to bill for acupuncture services that are performed to treat various health conditions, such as pain relief, post-operative and chemotherapy nausea and vomiting, stroke rehabilitation, asthma, addiction, and more.

2. 97810 CPT code description

The official description of CPT code 97810 is: “Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient.”

3. Procedure

The 97810 procedure involves the following steps:

1. The provider selects appropriate needle lengths and locates critical points on the patient’s body by pressing on the skin and feeling them with their fingers.
2. The provider marks the location by pushing down on the skin and cleaning the site.
3. The provider carefully inserts the solid, metallic, hair-thin, disposable needles at the marked points.
4. The needles are mildly stimulated by various techniques, such as rotating the needle or inserting and withdrawing the needle repeatedly, depending on the desired effect.
5. The patient is instructed to rest for a period of time with the needles still inserted.
6. The provider returns periodically to check on the patient and readjust the needles as necessary.
7. Once the desired effect is achieved, the provider removes and disposes of the needles and presses on the points with a cotton ball to prevent bruising or bleeding.
8. The provider gives the patient post-procedure instructions and documents the procedure in the patient’s chart.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 97810 services are those who require acupuncture treatment for various health conditions, such as pain relief, post-operative and chemotherapy nausea and vomiting, stroke rehabilitation, asthma, addiction, and more. The provider must determine if acupuncture is an appropriate treatment option for the patient based on their medical history, current condition, and any contraindications that may exist.

5. When to use CPT code 97810

It is appropriate to bill the 97810 CPT code when the provider performs an initial 15-minute acupuncture treatment using one or more needles without electrical stimulation. This code should be used for the first 15-minute increment of the treatment, regardless of whether it includes electrical or non-electrical stimulation. Subsequent 15-minute increments can be billed using +97811 or +97814, depending on whether manual or electrical stimulation is used during that additional time.

6. Documentation requirements

To support a claim for CPT 97810, the provider must document the following information:

• Patient’s medical history and current condition
• Indication for acupuncture treatment
• Specific acupuncture points used during the procedure
• Techniques used for needle insertion and stimulation
• Duration of the initial 15-minute one-on-one contact with the patient
• Provider’s assessment of the patient’s response to treatment
• Post-procedure instructions given to the patient

7. Billing guidelines

When billing for CPT code 97810, keep in mind the following guidelines:

• Only one initial acupuncture code can be reported per patient per date of service, as these codes include the complete initial service, including patient evaluation, set-up, and treatment.
• Acupuncture should be reported based on 15-minute increments of personal, face-to-face time with the patient, not the time the needles are in place.
• It is not appropriate to report 97810 or +97811, the non-electrical stimulation codes, in addition to 97813 and +97814, the electrical stimulation codes, for the same 15-minute increment.
• If the patient’s condition requires service above and beyond the usual scope of service associated with the acupuncture treatment, an E/M service can be reported separately by appending modifier 25. The E/M time is not included in the time of the acupuncture service.

8. Historical information

CPT 97810 was added to the Current Procedural Terminology system on January 1, 2005. The code was changed on January 1, 2006, with the previous descriptor being “Acupuncture, one or more needles, without electrical stimulation; initial 15 minutes of personal one-on-one contact with the patient.”

9. Similar codes to CPT 97810

Five similar codes to CPT 97810 and how they differentiate are:

• CPT 97811: This code is used for subsequent 15-minute increments of acupuncture treatment without electrical stimulation, requiring re-insertion of the needle or needles.
• CPT 97813: This code is used for the initial 15 minutes of acupuncture treatment with electrical stimulation.
• CPT 97814: This code is used for subsequent 15-minute increments of acupuncture treatment with electrical stimulation, requiring re-insertion of the needle or needles.
• CPT 97899: This code is used for unlisted acupuncture procedures that do not fit within the descriptions of the other acupuncture codes.
• CPT 97140: This code is used for manual therapy techniques, such as mobilization and manipulation, which may be performed in conjunction with acupuncture but are billed separately.

10. Examples

Here are 10 detailed examples of CPT code 97810 procedures:

1. A patient with chronic lower back pain receives an initial 15-minute acupuncture treatment without electrical stimulation to alleviate pain.
2. A patient undergoing chemotherapy receives an initial 15-minute acupuncture treatment without electrical stimulation to help manage nausea and vomiting.
3. A patient recovering from a stroke receives an initial 15-minute acupuncture treatment without electrical stimulation to aid in rehabilitation.
4. A patient with asthma receives an initial 15-minute acupuncture treatment without electrical stimulation to help improve respiratory function.
5. A patient with an addiction to opioids receives an initial 15-minute acupuncture treatment without electrical stimulation as part of a comprehensive treatment plan.
6. A patient with migraines receives an initial 15-minute acupuncture treatment without electrical stimulation to help prevent and manage headache symptoms.
7. A patient with fibromyalgia receives an initial 15-minute acupuncture treatment without electrical stimulation to help manage pain and improve overall well-being.
8. A patient with carpal tunnel syndrome receives an initial 15-minute acupuncture treatment without electrical stimulation to help alleviate pain and improve hand function.
9. A patient with irritable bowel syndrome receives an initial 15-minute acupuncture treatment without electrical stimulation to help manage gastrointestinal symptoms.
10. A patient with anxiety and depression receives an initial 15-minute acupuncture treatment without electrical stimulation as part of a comprehensive mental health treatment plan.