Coding and Billing for Outpatient Rehab Made Easy

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❚❘❘ Frequently asked CPT and HCPCS questions
Can we use CPT code 99070 for reusable patient specific electrodes?
Medicare Part B therapy services considers supplies to be part of the practice expenses.
Under the Medicare physician fee schedule, these expenses are already taken into
account in the practice expense relative values. This is also true for most other thirdparty
payers. Two exceptions could be automobile-related and workers’ compensation
claims. Before billing 99070, check with those payers. Personally, I do not recommend
using that CPT code.
Can we bill four contact units (i.e., 55–60 minutes) and still include electrical stimulation (97014),
which is untimed for both Medicare and other payers?
I assume that the minutes for unattended electrical stimulation are in addition to the
55–60 minutes. If that assumption is accurate, then the answer is yes. Using Medicare’s
“eight-minute rule,” if you provided 55–60 minutes of direct one-on-one modalities and
therapeutic procedures, you would be able to bill four units of timed-based procedures
since your treatment time was at least 53 minutes but less than 68 minutes. The unattended
electrical stimulation is not included in the minutes of the timed codes and is
automatically billed as one unit. Remember, for Medicare Part B therapy services, you
need to use G0283 for unattended electrical stimulation for indications other than
wound care, not 97014. 4
Does the new 97597 CPT code include dressing changes? If not, what CPT code do you use? I
know 97597 includes whirlpool treatment, but can you actually bill 97597 and 97022 together as
long as 97022 is modified?
If you provide selective debridement (97597 or 97598), the dressing change is included
in the reimbursement for 97597 and 97598. If you provide wound care without
selective debridement and without whirlpool, bill for non-selective debridement
(97602). The reimbursement includes the cost of the dressings (Medicare reimburses
zero dollars for 97602).
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