What CPT Code to Bill for Dry Needling

June 25, 2018
Rick Gawenda

As more and more therapists are getting trained in dry needling, I receive more questions on what CPT code do I bill for the dry needling techniques? According to APTA, “Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. It is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and to diminish persistent peripheral nociceptive input, and reduce or restore impairments in body structure and function, leading to improved activity and participation.”

So now that we have defined what dry needling is, what CPT code do we bill to be paid for our services? Many providers think or are told to bill for dry needling using CPT code 97140, Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes. But is this the correct code to use? What does the American Medical Association (AMA) say about what is included in CPT code 97140 and why do we care what the AMA says?

The reason we care what the AMA states is that the AMA is the organization that develops the CPT codes, provides the description of the CPT codes and provides the guidance of what is included and not included within each CPT code. Each month, the AMA releases a publication called CPT Assistant and in this publication, the AMA answers questions submitted by providers and provides additional guidance concerning a particular CPT code and what is and what is not included in each CPT code.

In the May 2009 edition of CPT Assistant, the AMA answered the following question: “What types of manual therapy techniques would be reported with CPT code 97140”? Their answer is as follows:

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  1. I am interested in hearing what CPT code people are using to bill the use of Graston or IASTM. They are not directly using their hands, but indirectly through the use of a tool similar to a therapist using their hands to insert a needle. All 3 techniques are being used to help provide a similar result through a different method. What is being used for Graston and IASTM, and if it is the 97140, why is it different from dry needling? Thank you.

    1. You would need to check with the insurance carrier as I have seen several therapy policies where the insurance carrier considers some of this techniques experimental and investigational and they are not covered by the insurance carrier.

    1. You would have to look at your insurance carrier contract and their policies concerning billing patients for noncovered services.

  2. If we have a Medicare patient complete an ABN prior to Dry Needling and they select Option 1, would we then bill CPT 97799 for Dry Needling?

    1. Either 97799 or 97139 and attach the GA modifier to that CPT code in addition to the GP modifier.

  3. If E-Stim (97014) is performed in conjunction with the dry needling (attached to needles) is it appropriate to bill for both the unlisted procedure and the E-stim, or do CCI edits prevent this?