procedure code description
97014 Electric stimulation therapy
97014 — electrical stimulation unattended (NOTE: 97014 is not recognized by Medicare. Use G0283 when reporting unattended electrical stimulation for other than wound care purposes as described in G0281 and G0282.)
Reporting of CPT Code 97014 and HCPCS G0283
With the implementation of the January 2003 HCPCS Update, CPT code 97014 “application of a Modality tone or More Areas; electrical stimulation (unattended)” was deleted without a grace period effective January 1, 2003. The replacement HCPCS code, G0283, “electrical stimulation (unattended), to one or more areas, for indication(s) other than wound care as part of a therapy plan of care”, was also made effective January 1, 2003. However, in accordance with CMS? coverage determination policy, HCPCS code G0283 will not become effective until April 1, 2003. In order to process claims for this service for the period, January 1, 2003 through March 31, 2003, the following procedures should be followed.
Your Fiscal Intermediary (FI) has updated the HCPCS files to allow CPT code 97014 to process for claims containing dates of service January 1, 2003 through March 31, 2003. Payment should be made at the 2002 payment rate. Hospitals should report CPT code 97014 through March 31, 2003. The replacement HCPCS code G0283 will be effective April 1, 2003, and may be reported for claims with dates of service April 1, 2003 and later.
In situations where hospitals may have already submitted a claim containing 97014 and other services, providers may submit an adjustment claim in order to receive payment for CPT code 97014. Claims that have been returned containing this code, may be re-submitted for processing.
This applies to the following states: Minnesota and North Dakota
Billing and Coding Guidelines
This policy describes Optum methodology and requirements for reimbursement of procedure code 97014 (Application of a modality to one or more areas; electrical stimulation [unattended]). Optum will not reimburse for procedure code 97014. Unattended electrical stimulation will remain a reimbursable service however providers utilizing this modality will not be reimbursed for procedure code 97014. In accordance with CMS National Coding Policy, providers should submit the appropriate HCPCS G-code which more accurately represents the service rendered.
Provide more specificity to the generalized procedure 97014 electrical stimulation code definition to better enable more accurate tracking, trending, and data retrieval ability relative to provider specific use of electrical stimulation. Effective with CMS National Coding Policy, January 1, 2003, procedure 97014 unattended electrical stimulation was cross-walked to new G codes.
Rationale for Edit:
Anthem Central Region bundles G0238 as redundant/mutually exclusive to 97014. G0238 is a HCPCS code listing electrical stimulation service and 97014 is a procedure code that is for electrical stimulation. So both of these codes are state the same text but are from different National Coding structures. Therefore, if G0238 is submitted with 97014—only 97014 reimburse.
There are no specific procedure codes describing interferential current stimulation. The following procedure codes might be used: 64550, 97014
The following HCPCS code might also be used:
G0283: Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care.
G0238 (Electrical stimulation {unattended}, to one or more areas for indication(s) other than wound care, as part of a therapy plan of care) bundles with 97014 (Application of a modality to one or more areas: electrical stimulation (unattended})
Background
Nerve blocks, injections of local anesthetic solutions, cause the temporary interruption of conduction of impulses in peripheral nerves or nerve trunks.
There are also early studies using electrostimulation with or without nerve blocks for treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases.
Limitations
The use of nerve blocks with or without the use of electrostimulation, and the use of electrostimulation alone for the treatment of multiple neuropathies or peripheral neuropathies caused by underlying systemic diseases is not considered medically reasonable and necessary. Medical management using systemic medications is clinically indicated for the treatment of these conditions.
At present, the literature and scientific evidence supporting the use of peripheral nerve blocks with or without the use of electrostimulation, and the use of electrostimulation alone for neuropathies or peripheral neuropathies caused by underlying systemic diseases, is insufficient to warrant coverage. These procedures are considered investigational and are not eligible for coverage for the treatment of neuropathies or peripheral neuropathies caused by underlying systemic diseases.
ICD-10 CODE DESCRIPTION
A52.15 Late syphilitic neuropathy
E08.40 – E08.43 – Opens in a new window Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified – Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
E09.40 – E09.43 – Opens in a new window Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified – Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
E10.40 – E10.43 – Opens in a new window Type 1 diabetes mellitus with diabetic neuropathy, unspecified – Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
E11.40 – E11.43 – Opens in a new window Type 2 diabetes mellitus with diabetic neuropathy, unspecified – Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
E13.40 – E13.43 – Opens in a new window Other specified diabetes mellitus with diabetic neuropathy, unspecified – Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
G13.0 Paraneoplastic neuromyopathy and neuropathy
G56.40 – G56.92 – Opens in a new window Causalgia of unspecified upper limb – Unspecified mononeuropathy of left upper limb
G57.70 – G57.92 – Opens in a new window Causalgia of unspecified lower limb – Unspecified mononeuropathy of left lower limb
G58.7 – G65.2 – Opens in a new window Mononeuritis multiplex – Sequelae of toxic polyneuropathy
M05.50 – M05.59 – Opens in a new window Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site – Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites
M34.83 Systemic sclerosis with polyneuropathy
M79.2 Neuralgia and neuritis, unspecified
M79.601 – M79.676 – Opens in a new window Pain in right arm – Pain in unspecified toe(s)
