Electrical Stimulation and One-on-One Interventions at the Same Time: How to Bill
I am often asked what is the correct billing when I set a patient up on unattended electrical stimulation and then while the patient is on the unattended electrical stimulation, I am also providing them with skilled one-on-one interventions that would be included within therapeutic exercise, neuromuscular reeducation and/or therapeutic activities. In this article, I will provide the answer to this billing question with the rationale for the answer.
Question
What is the correct billing when I set a patient up on unattended electrical stimulation and then while the patient is on the unattended electrical stimulation, I am also providing them with skilled one-on-one interventions that would be included within therapeutic exercise, neuromuscular reeducation and/or therapeutic activities and would allow the billing of 1 or more units of the applicable one-on-one code(s)?
Answer
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Can you bill just ultrasound or just electrical stim on a visit? If yes, can it be billed for several visits in a row?
If you do just an ultrasound or only provide unattended e-stim, that is what you would bill. To bill the ultrasound, you would have to perform it for enough minutes.
So if I’m reading correctly, if I set a patient up on NMES and have them perform SAQ, SLR, etc then I can bill 97914 AND 97110 for the same overlapping period (97014 would also include the set up time prior to the actual unit working while performing exercise.
It’s possible to bill an untimed supervised modality and a 15-minute one-on-one time-based code during the same time period.
Is this still true for 2024? This article by Medicare says that you cannot bill 97014 and 97110 if performed in the same 15 minutes. https://www.cms.gov/medicare-coverage-database/view/article.aspx?LCDId=33631&articleId=56566&NCSelection=NCD&KeyWord=negative+pressure&KeyWordLookUp=Doc&KeyWordSearchType=Exact&kq=true
The answer in my article is correct.
From the LCD: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53065&ver=67&=
Most non-wound care electrical stimulation treatment provided as part of a therapy plan of care should be billed as G0283 as it is often provided in a supervised manner (after skilled application by the qualified professional/assistive personnel) without constant, direct contact required throughout the treatment. Do you interpret that as the skilled application would be billed as 97032 and the unsupervised G0283 would be billed after the skilled application? For example, determining/setting up electrode placements for FES30 minutes =97032x 2 units then the next 30 minutes supervising FES would be G0283 x 1 unit?
No! Just setting up a patient on electrical stimulation does not mean it is 97032.
Can you provide any clarity on NMES vs Russian E-stim. Your article references a CMS document showing that untimed and timed procedures can be billed together. However, this CMS document states NMES is timed (97032) while Russian is untimed (G0283). They seem to be used in very similar manners so it’s confusing why CMS would differentiate them.
https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56566
NMES and russian are both types of electrical stimulation. I can’t comment on what CMS is thinking.