Re: Electrical Stimulation - Blue Cross Coverage

[Guest guest]

Pat, For the most part, G0283 and 97014 are not covered by BCBS in IL. It is

termed as experimental. This includes TENS, IOnto, etc. Mechanical traction is

also included as experimental. That is my understanding. You need to really

educate the pt to check their individual plan because some sub plans will cover,

otherwise, they get a big bill from the hospital/clinic. Makes for fun times.

Call me with ??

Todd Mourning, PT

Manager of Therapy Services

Abraham Lincoln Memorial Hospital

315 8th Street

Lincoln, IL 62656

(direct)

(fax)

mourning.todd@...

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Cornwell

Sent: Wednesday, January 30, 2008 9:55 AM

To: PTManager

Subject: Electrical Stimulation - Blue Cross Coverage

Is anyone getting denials for Electrical Stimulation,

HCPCS Code GO283? If I am reading the Blue Cross

Medical Policy correctly, it is not a covered service

in Illinois, Texas, Oklahoma and New Mexico.

Pat Cornwell

Director PT

Palos Community Hospital

Palos Heights, Il. 60463

Pat Cornwell

Dir. of Rehab Services

Palos Community Hospital

Palos Heights, Illinois

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[Guest guest]

We use the code 97032 E-Stim manual and get paid by Blue Cross.

Joan

www.PDRehab.com

> Is anyone getting denials for Electrical Stimulation,

> HCPCS Code GO283? If I am reading the Blue Cross

> Medical Policy correctly, it is not a covered service

> in Illinois, Texas, Oklahoma and New Mexico.

> Pat Cornwell

> Director PT

> Palos Community Hospital

> Palos Heights, Il. 60463

>

> Pat Cornwell

> Dir. of Rehab Services

> Palos Community Hospital

> Palos Heights, Illinois

>

>

>

>

________________________________________________________________________________\

____

> Looking for last minute shopping deals?

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>

[Guest guest]

G0283 is only for Medicare patients, all others use 97032

Pam

Pamela G. Unger, PT, CWS

Celleration MIST Therapy

Vice President of Clinical Research and Reimbursement

(Cell)

(Office)

(Corporate office)

punger@...

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Joan

Sent: Wednesday, January 30, 2008 10:26 AM

To: PTManager

Subject: Re: Electrical Stimulation - Blue Cross Coverage

We use the code 97032 E-Stim manual and get paid by Blue Cross.

Joan

www.PDRehab.com

> Is anyone getting denials for Electrical Stimulation,

> HCPCS Code GO283? If I am reading the Blue Cross

> Medical Policy correctly, it is not a covered service

> in Illinois, Texas, Oklahoma and New Mexico.

> Pat Cornwell

> Director PT

> Palos Community Hospital

> Palos Heights, Il. 60463

>

> Pat Cornwell

> Dir. of Rehab Services

> Palos Community Hospital

> Palos Heights, Illinois

>

>

>

> __________________________________________________________

> Looking for last minute shopping deals?

> Find them fast with Yahoo! Search.

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[Guest guest]

What one needs to remember is that you bill the

appropriate CPT code based on the type of electrical

stimulation that you provide. If providing unattended

electrical stimulation, the appropriate CPT code for

BCBS in those states is 97014. If providing manual

electrical stimulation, the appropriate CPT code is

97032. I would recommend you reading the BCBS PT

policy that is on their website. Here is the link.

Scroll down and click accept and then click view all

policies.

http://medicalpolicy.hcsc.net/medicalpolicy/disclaimer#hlink

Rick Gawenda, PT

President, Section on Health Policy & Administration

APTA

--- Joan wrote:

> We use the code 97032 E-Stim manual and get paid by

> Blue Cross.

> Joan

> www.PDRehab.com

>

> > Is anyone getting denials for Electrical

> Stimulation,

> > HCPCS Code GO283? If I am reading the Blue Cross

> > Medical Policy correctly, it is not a covered

> service

> > in Illinois, Texas, Oklahoma and New Mexico.

> > Pat Cornwell

> > Director PT

> > Palos Community Hospital

> > Palos Heights, Il. 60463

> >

> > Pat Cornwell

> > Dir. of Rehab Services

> > Palos Community Hospital

> > Palos Heights, Illinois

> >

> >

> >

> >

>

________________________________________________________________________________\

____

> > Looking for last minute shopping deals?

> > Find them fast with Yahoo! Search.

> >

>

http://tools.search.yahoo.com/newsearch/category.php?category=shopping

> >

>

>

>

>

>

________________________________________________________________________________\

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[Guest guest]

I have read the Medical Policies on the BCBS website.

There is a policy stating that electrical stimulation

with surface electrodes is not covered. We use the

HCPCS GO283 (unatttended estim) because our system is

set-up for Medicare compliance. We have been getting

paid.

--- Rick Gawenda wrote:

> What one needs to remember is that you bill the

> appropriate CPT code based on the type of electrical

> stimulation that you provide. If providing

> unattended

> electrical stimulation, the appropriate CPT code for

> BCBS in those states is 97014. If providing manual

> electrical stimulation, the appropriate CPT code is

> 97032. I would recommend you reading the BCBS PT

> policy that is on their website. Here is the link.

> Scroll down and click accept and then click view all

> policies.

>

>

http://medicalpolicy.hcsc.net/medicalpolicy/disclaimer#hlink

>

> Rick Gawenda, PT

> President, Section on Health Policy & Administration

> APTA

>

>

> --- Joan wrote:

>

> > We use the code 97032 E-Stim manual and get paid

> by

> > Blue Cross.

> > Joan

> > www.PDRehab.com

> >

> > > Is anyone getting denials for Electrical

> > Stimulation,

> > > HCPCS Code GO283? If I am reading the Blue

> Cross

> > > Medical Policy correctly, it is not a covered

> > service

> > > in Illinois, Texas, Oklahoma and New Mexico.

> > > Pat Cornwell

> > > Director PT

> > > Palos Community Hospital

> > > Palos Heights, Il. 60463

> > >

> > > Pat Cornwell

> > > Dir. of Rehab Services

> > > Palos Community Hospital

> > > Palos Heights, Illinois

> > >

> > >

> > >

> > >

> >

>

________________________________________________________________________________\

____

> > > Looking for last minute shopping deals?

> > > Find them fast with Yahoo! Search.

> > >

> >

>

http://tools.search.yahoo.com/newsearch/category.php?category=shopping

> > >

> >

> >

> >

> >

> >

>

>

>

>

>

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>

>

Pat Cornwell

Dir. of Rehab Services

Palos Community Hospital

Palos Heights, Illinois

________________________________________________________________________________\

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