I am concerned, as I am at the start of every new year, on what is new or changing. Are there new diagnostic codes for acupuncture professionals? Also are we changing to ICD10 from ICD9? Finally, are there any new CPT codes for treatment from an acupuncturist such as acupuncture, exams, or physical medicine services that are commonly used by practitioners?
I want to first address the issue of ICD10. Diagnoses are internationally recognized and not limited due to language barriers. Consequently they are categorized by a numeric system (numbers being universal) to describe and code illness, disease, injuries, etc., with the system we call International Classification of Diseases (ICD). The current system used the United States, is the 9th revision which was adopted in 1979. This version is becoming obsolete as it does not meet current and future demands for healthcare data. Therefore there is a current movement towards the use of ICD10.
However, this 10th revision is not scheduled for use until Oct. 1, 2013 and any use currently would be erroneous. Additionally, my experience with changes of this magnitude is that they are often delayed or postponed and I would not be surprised if the October 2013 deadline is extended or amended. When and if it implements, will be very big news and this publication and author will be sure the acupuncture profession is readily informed and ready for the change.
The current coding system that is used is ICD9, which has revisions and updates each year that may include new codes and/or updates to existing codes. Often you will hear that there are thousands of changes, which technically may be true. However, a grammatical or punctuation change is the most common and that is generally the majority. For 2011 there are changes. But are these changes significant to acupuncture professionals? The short answer is no.
There is one new code for pain, specifically jaw (mandibular or maxilla) pain, which is 784.92
For the acupuncture professional the last significant changes to codes commonly used were, in 2009 with the addition of 35 new codes for headaches, and in 2007 with the addition of new pain codes for acute and chronic pain.
The diagnosis codes most commonly used and paid by insurance for acupuncture services such as pain, osteoarthrosis, headaches, nausea, vomiting, all remain as they were in 2010. If you would like a list of common codes paid by insurance for acupuncture I will send you one via an e-mail response to
Of special note, there is a committee of acupuncture professionals and other healthcare experts working on behalf of acupuncturists to include in the ICD11 (yes, this revision is being worked on internationally) specific diagnosis for acupuncture and not just the standard pain and symptom codes currently used.
CPT (Current Procedural Terminology) codes for 2011 also have no updates pertinent to the acupuncture professional. The last significant change was in 2005 when the acupuncture codes were updated to 97810, 97811, 97813 and 97814. Physical medicine and rehabilitation codes (many refer to these, though incorrectly, as physical therapy codes) which describe physical medicine services such has heat, massage, exercise, etc. They also have no changes in 2011. While not all codes for physical medicine may be within the scope of practice for your particular state, most states do allow acupuncturists a limited scope to apply several of these services. There are also no updates to the codes used for examination (evaluation and management 99201 through 99205 and 99211 through 99215) which would or could be used by an acupuncturist to code the services and time for the initial and follow up history and examination of their patients.
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