Q: I recently heard that the code for electrical stimulation changed to a "G" code. Is this true, and what type of service does the code designate?
A: The Current Procedural Terminology (CPT) code for electrical stimulation, unattended 97014, was changed to G0283 approximately two years ago for Medicare claims. This "G" code is a Health Care Common Procedure Coding System (HCPCS) code. It is specifically designated as electrical stimulation (unattended) to one or more areas for indication(s) other than wound care, as part of a therapy plan for care.
This designation was made to discern when electrical stimulation is done for "wound care," for which there are separate codes. While this change from Medicare has been present for more than two years, most offices did not take note, as Medicare of course does not pay chiropractic doctors for this service, and many offices do not bill non-covered services to Medicare unless they need a denial to bill a secondary payer.
The use of the new "G" code quickly became evident to doctors who were billing Medicare for a denial. In those cases, if 97014 were billed to Medicare, it would come back as an invalid code and, consequently, had neither patient responsibility nor any payment from the secondary insurance.
But until January 2007, G0283 was only used for Medicare claims and may have gone somewhat unnoticed. However, in January, United Healthcare also began requiring the code G0283 instead of 97014. Therefore, all claims to United Healthcare must use G0283 for unattended electrical stimulation, since 97014 will be denied as an invalid code. United Healthcare providers should have received notice of this in December 2006 via a newsletter from the insurer. But based on the number of questions I have received regarding this code, it seems the newsletter did not reach its entire intended audience.
The bottom line in answering your question is that only for Medicare and United Healthcare should you use the code G0283. For all others, continue to use 97014. Whether other carriers will follow suit remains to be seen. I will monitor if others make the transition and will comment in a future column, should it come to fruition.
On a quick side note, United Healthcare is now also bundling 97010, hot or cold packs, as part of the primary procedure. Simply put, it is no longer paying for hot or cold packs when done with other services the same day. The American Chiropractic Association, along with other allied professional groups, is taking action to fight this policy change.
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