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Taking a Closer Look at ICD-10 for Acupuncture

By now, I hope you have heard that ICD-10 diagnoses will be required for billing insurance for acupuncture come October 1, 2015. Here is a closer look at some frequently asked questions.

Do I bill all claims in ICD-10 for acupuncture after September 30?

No, claims for dates of service before October 1, 2015 must be coded using ICD-9, regardless of when you actually send out the claim. So it is only claims for dates of service on or after October 1, 2015 that must be coded using ICD-10 codes.


How would I handle Worker‘s Comp and Auto Insurance claims?

As of this writing, both worker‘s comp and auto insurance are to be billed with ICD-9 codes.


Can I just bill my claims with both ICD-9 and ICD-10 codes on them?

No, claims cannot contain both codes sets. CMS also created a Provider Resources page which contains educational material as well as a Quick Start Guide to assist you along the way.


Will payer policies change with ICD-10?

Pain codes are usually reimbursed by insurance companies for acupuncture. General internal medicine conditions such as lupus, IBS, infertility, etc. are usually rejected. The new ICD-10 code set does not change this bias. It is still up to individual health insurance providers to determine the diagnosis codes that are deemed reimbursable for licensed acupuncturists.


Do you have a list of common ICD-10 codes for acupuncture that I can use?

We sure do. You can download a list of the new codes from here: Common ICD-10 Codes for Acupuncture

September 11, 2015
 - by Antonio Arias, MBA, CHBME
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