Dry Needling CPT Codes Added for 2020
Changes occur to CPT procedure codes every January 1st. Some get deleted, some updated, and others added. The list of new codes added for 2020 include 2 new procedure codes for dry needling: 20560 and 20561. This is great news for doctors who incorporate this service into their practice and for years have had to use an unspecified code. Before you start billing, make sure you have a good understanding of what these codes entail.
What is dry needling?
Dry needling is a procedure where a very thin needle is inserted into the skin and muscle, targeting myofascial trigger points. The depth of needle insertion, whether the needle is manipulated in any way while inserted, and the use of electrical stimulation in association with needling is at the provider’s discretion based on the patient’s condition. The goal of this treatment is to relieve pain, minimize the trigger points, and promote healing in the treated area.
Coding for dry needling is as follows:
- CPT® Code 20560: Needle insertion(s) without injection(s), 1-2 muscles
- CPT® Code 20561: Needle insertion(s) without injection(s), 3 or more muscles
These procedure codes are based on the number of muscles being treated. The number of needles used, and time spent with the patient is not taken into consideration when determining the appropriate code to use. Only one unit of this code can be billed per encounter. Dry needling can be performed on the same day and same spinal or body region as a manipulation (CPT ® Codes 98940-98943), massage (CPT ® Code 97124), or manual therapy (CPT ® Code 97140) due to the fact that dry needling requires a very different skill set to perform and the post service work, such as documentation and home care instructions, are different from what is required for other chiropractic and soft tissue services.
Is dry needling covered by your patients provider?
Even if dry needling is within a provider’s scope of practice, it does not mean that payers will reimburse for this service. Many third-party payers consider dry needling to be “experimental and investigational” and consider it an excluded service. Locate and review the Medical Review Policies for any payers your office commonly bills to and verify patients’ insurance benefits to confirm if they provide coverage for this service. Some require that patients sign a notice of non-coverage prior to receiving treatment to ensure they are aware of their personal financial responsibility.
Having specific procedure codes for dry needling is extremely helpful for office statistics whether it is a cash or insurance reimbursed service. As with all diagnosis and procedure codes, stay informed on the yearly changes and update your internal paperwork, fee schedule, and billing system as needed.
Medicare, Coding, and Other 2020 Updates You Need to Know
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