How to Do Medical Billing for Acupuncture?

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Medical Billing for Acupuncture

Medical bills can be complicated, especially for acupuncturists just starting. It’s like learning a new language: as you practice, it becomes more straightforward. Billing correctly and on time would be best to keep your acupuncture practice’s cash flow healthy.

This blog post will clarify medical billing for acupuncture and give you the information you need to manage this vital part of your business effectively.

Understanding Acupuncture Medical Billing Codes

An ancient technique with roots in Chinese medicine is acupuncture. It includes putting thin needles into specific body parts to increase energy flow, which helps the body heal. Acupuncture can help with physical and emotional health concerns like stress and worry.

For medical billing, CPT codes are like coded secret language. They are unique codes that an acupuncturist uses to talk about what they do. If you want to get paid for your services by insurance companies, you need to know how to use CPT codes correctly. Using the correct codes to ensure proper reimbursement and avoid billing errors is essential.

We’ll break down the most common CPT codes used in acupuncture: (1)

  • 97810 – Initial 15 minutes without electrical stimulation
  • 97811 – Each additional 15 minutes without electrical stimulation
  • 97813 – Initial 15 minutes with electrical stimulation
  • 97814 – Each additional 15 minutes with electrical stimulation

Billing for New Patients

You need to use specific codes and keep records to bill new clients. Consider these essential points:

  • New Patient Definition: A new patient has yet to see you or another doctor in the same field in the last three years.
  • New Patient Evaluation Codes: 99201 to 99205—evaluation and care of a new patient in an office or other outpatient setting. These codes require a full medical background, an exam, and medical decisions based on the case’s complexity.

Billing for Established Patients

  • Established Patient Definition: An established patient is a patient who has seen you or another doctor in the same field in the last three years.
  • Established Patient Evaluation Codes: 99211 to 99216 – An outpatient visit to an office or other location to review and treat a known patient. These codes need at least two of the following – a background that focuses on the problem, an exam, and making medical decisions.

Billing for Physical Therapy-Based Treatments

Acupuncture is often used for physical therapy-based treatments, requiring special codes and paperwork. Consider these essential points:

Common Physical Therapy Codes

  • 97140 – Manual therapy techniques
  • 97110 – Therapeutic exercises
  • 20550/20551 – Tendon injection
  • 20552/20553 – Muscle injection

Why is Medical Billing for Acupuncture Practices Important?

Billing isn’t just about getting paid; it’s also about ensuring the acupuncture clinic runs efficiently. If the bills are correct, the clinic gets paid on time, which keeps the doors and lights open. It also ensures that the clinic follows all the rules and laws set by healthcare officials, keeping patients safe and satisfied.

Related: How Does Medical Billing Outsourcing Impacts Revenue?

Critical Components of Medical Billing for Acupuncture

1. Patient Registration and Information Gathering

Before beginning any treatment, acupuncturists must gather comprehensive information about their patients, including essential details such as their name, address, and contact information.

Additionally, obtaining insurance information is crucial to understanding how the patient will cover the cost of their acupuncture billing treatments. By collecting this information upfront, acupuncturists can ensure smooth billing processes and avoid delays in reimbursement (2).

2. Insurance Verification and Eligibility

Checking a patient’s insurance is like checking if your favorite shop takes credit cards. Acupuncturists need to check with their patients to see if their insurance covers acupuncture sessions and, if not, how much they need to pay out of pocket.

This step is crucial for ensuring that both the acupuncturist and the patient know what to expect regarding payment and policy limits.

Related: What is Eligibility Verification in Medical Billing?

3. Coding for Acupuncture Procedures

Coding for acupuncture treatments is like grouping things so they are easy to find and price. Acupuncturists utilize Current Procedural Terminology (CPT) codes to explain their treatments throughout each session.

These codes help make bills more consistent and let insurance companies know what services were provided. Acupuncturists can accurately classify acupuncture treatments to assure payment for their services.

4. Documentation Requirements

The most important part of acupuncture insurance billing is keeping good records. Acupuncturists have to keep detailed records of every patient visit. These records should include a list of the treatments given, why those treatments were chosen, and any relevant patient information or reactions. This paperwork is an in-depth record of the care provided and is needed to show that the services were medically necessary.

Related: How Does Medical Billing Outsourcing Impacts Revenue?

5. Submission of Claims

The last step in medical billing is sending bills to insurance companies. Acupuncturists can send claims electronically or on paper based on what works best for them and their resources. Electronic submission has benefits like faster processing times and a lower chance of mistakes, but paper submission may be better in some cases.

Best Practices for Successful Medical Billing in Acupuncture

1. Staff Training and Education

Keep the clinic updated on the most recent billing practices and regulations. It ensures that every stakeholder understands what to do and is on the exact same page.

2. Utilization of Technology and Software Solutions

Acupuncture billing software can make the payment process more straightforward. Electronic systems and specialized software can make things faster and more efficient.

3. Outsourcing Options for Billing Services

For some clinics, it might make sense to outsource the billing process to experts who specialize in this area. It’s like hiring a professional plumber to fix a leaky pipe – sometimes, it’s best to leave it to the pros.

Do You Need Help Navigating the Complexities of Acupuncture Medical Billing?

Unlock the potential of your acupuncture practice with our EZMD Solutions expert acupuncture medical billing services.

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Wrapping it Up

Expertise in medical billing for acupuncture is essential for acupuncture businesses to be successful. Knowing the details of billing processes, following best practices, and keeping up to date on changes to regulations can help practitioners confidently handle the complicated billing world, ensuring their patients’ satisfaction and the practice’s financial health.

Learning to do medical billing is helpful for you and your patients, no matter how long you’ve been practicing acupuncture or how new you are to exploring alternative medicine. Using EZMD options, you can make things easier and focus on what matters. We are helping your people in the best way we can. Start saving money right away by looking into EZMD acupuncture billing options!

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