Local Coverage Article Billing and Coding

Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy

A56731

Expand All | Collapse All

Contractor Information

Article Information

General Information

Article ID
A56731
Article Title
Billing and Coding: Nerve Blocks and Electrostimulation for Peripheral Neuropathy
Article Type
Billing and Coding
Original Effective Date
07/25/2019
Revision Effective Date
01/01/2023
Revision Ending Date
N/A
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2022 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2022 American Dental Association. All rights reserved.

Copyright © 2022, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) states that no payment shall be made to any provider for any claim which lacks the necessary information to process the claim.

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Nerve Blocks and Electrostimulation for Peripheral Neuropathy L37642.

Use of Physical Medicine and Rehabilitation CPT/HCPCS Codes (97032, 97139, G0282, G0283) for these treatments is inappropriate.

Coding Information

CPT/HCPCS Codes

Group 1

(1 Code)
Group 1 Paragraph

N/A

Group 1 Codes
CodeDescription
64450 INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; OTHER PERIPHERAL NERVE OR BRANCH

Group 2

(4 Codes)
Group 2 Paragraph

Note: Use of the following Physical Medicine and Rehabilitation CPT/HCPCS Codes for these treatments is inappropriate:

Group 2 Codes
CodeDescription
97032 APPLICATION OF A MODALITY TO 1 OR MORE AREAS; ELECTRICAL STIMULATION (MANUAL), EACH 15 MINUTES
97139 UNLISTED THERAPEUTIC PROCEDURE (SPECIFY)
G0282 ELECTRICAL STIMULATION, (UNATTENDED), TO ONE OR MORE AREAS, FOR WOUND CARE OTHER THAN DESCRIBED IN G0281
G0283 ELECTRICAL STIMULATION (UNATTENDED), TO ONE OR MORE AREAS FOR INDICATION(S) OTHER THAN WOUND CARE, AS PART OF A THERAPY PLAN OF CARE

CPT/HCPCS Modifiers

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

(1 Code)
Group 1 Paragraph

N/A

Group 1 Codes
CodeDescription
XX000 Not Applicable

ICD-10-CM Codes that DO NOT Support Medical Necessity

Group 1

(129 Codes)
Group 1 Paragraph

N/A

Group 1 Codes
CodeDescription
A52.15 Late syphilitic neuropathy
E08.40 - E08.43 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified - Diabetes mellitus due to underlying condition with diabetic autonomic (poly)neuropathy
E09.40 - E09.43 Drug or chemical induced diabetes mellitus with neurological complications with diabetic neuropathy, unspecified - Drug or chemical induced diabetes mellitus with neurological complications with diabetic autonomic (poly)neuropathy
E10.40 - E10.43 Type 1 diabetes mellitus with diabetic neuropathy, unspecified - Type 1 diabetes mellitus with diabetic autonomic (poly)neuropathy
E11.40 - E11.43 Type 2 diabetes mellitus with diabetic neuropathy, unspecified - Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
E13.40 - E13.43 Other specified diabetes mellitus with diabetic neuropathy, unspecified - Other specified diabetes mellitus with diabetic autonomic (poly)neuropathy
G13.0 Paraneoplastic neuromyopathy and neuropathy
G56.40 - G56.92 Causalgia of unspecified upper limb - Unspecified mononeuropathy of left upper limb
G57.70 - G57.92 Causalgia of unspecified lower limb - Unspecified mononeuropathy of left lower limb
G58.7 - G65.2 Mononeuritis multiplex - Sequelae of toxic polyneuropathy
M05.50 - M05.59 Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site - Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites
M34.83 Systemic sclerosis with polyneuropathy
M35.06 Sjogren syndrome with peripheral nervous system involvement
M79.2 Neuralgia and neuritis, unspecified
M79.601 - M79.676 Pain in right arm - Pain in unspecified toe(s)

ICD-10-PCS Codes

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

N/A

Other Coding Information

N/A

Revision History Information

Revision History DateRevision History NumberRevision History Explanation
01/01/2023 R5

Under CPT/HCPCS Codes Group 2: Codes the description was revised for 97139. This revision is due to the 2023 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/23.

10/01/2021 R4

Under ICD-10 Codes that DO NOT Support Medical Necessity Group 1: Codes added M35.06. This revision is due to the Annual ICD-10 Update and will become effective on 10/1/21.

01/01/2020 R3

Under CPT/HCPCS Codes Group 1: Codes the code description was revised for CPT® code 64450. This revision is due to the Annual CPT®/HCPCS Code Update and becomes effective on 1/1/20.

10/10/2019 R2

This article is being revised in order to adhere to CMS requirements per chapter 13, section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs and incorporate into related Billing and Coding Articles. Title XVIII of the Social Security Act, §1833(e) was removed from the CMS National Coverage Policy section of the related Nerve Blocks and Electrostimulation for Peripheral Neuropathy L37642 LCD and placed in this article. Under Article Text deleted the subheading Utilization Guidelines.

07/25/2019 R1

All coding located in the Coding Information section has been removed from the related the Nerve Blocks and Electrostimulation for Peripheral Neuropathy L37642 LCD and added to this article.

Associated Documents

Related National Coverage Documents
N/A
Statutory Requirements URLs
N/A
Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
N/A
Public Versions
Updated On Effective Dates Status
01/11/2023 01/01/2023 - N/A Currently in Effect You are here
08/25/2021 10/01/2021 - 12/31/2022 Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Nerve Blocks
  • Electrostimulation
  • Peripheral Neuropathy