BIlling Procedure 97014 and G0283

procedure code description 

97014 Electric stimulation therapy

97014 -- electrical stimulation unattended (NOTE: 97014 is not recognized by  Medicare. Use G0283 when reporting unattended electrical stimulation for other than  wound care purposes as described in G0281 and G0282.)

Reporting of CPT Code 97014 and HCPCS G0283

With the implementation of the January 2003 HCPCS Update, CPT code 97014 "application of a Modality tone or More Areas; electrical stimulation (unattended)" was deleted without a grace period effective January 1, 2003. The replacement HCPCS code, G0283, "electrical stimulation (unattended), to one or more areas, for indication(s) other than wound care as part of a therapy plan of care", was also made effective January 1, 2003. However, in accordance with CMS? coverage determination policy, HCPCS code G0283 will not become effective until April 1, 2003. In order to process claims for this service for the period, January 1, 2003 through March 31, 2003, the following procedures should be followed.

Your Fiscal Intermediary (FI) has updated the HCPCS files to allow CPT code 97014 to process for claims containing dates of service January 1, 2003 through March 31, 2003. Payment should be made at the 2002 payment rate. Hospitals should report CPT code 97014 through March 31, 2003. The replacement HCPCS code G0283 will be effective April 1, 2003, and may be reported for claims with dates of service April 1, 2003 and later.

In situations where hospitals may have already submitted a claim containing 97014 and other services, providers may submit an adjustment claim in order to receive payment for CPT code 97014. Claims that have been returned containing this code, may be re-submitted for processing.

This applies to the following states: Minnesota and North Dakota

Billing and Coding Guidelines

This policy describes Optum methodology and requirements for reimbursement of procedure code 97014 (Application of a modality to one or more areas; electrical stimulation [unattended]). Optum will not reimburse for procedure code 97014. Unattended electrical stimulation will remain a reimbursable service however providers utilizing this modality will not be reimbursed for procedure code 97014. In accordance with CMS National Coding Policy, providers should submit the appropriate HCPCS G-code which more accurately represents the service rendered.

Provide more specificity to the generalized procedure 97014 electrical stimulation code definition to better enable more  accurate tracking, trending, and data retrieval ability relative to provider specific use of electrical stimulation. Effective with CMS National Coding Policy, January 1, 2003, procedure 97014 unattended electrical stimulation was cross-walked to new G codes.

Rationale for Edit:

Anthem Central Region bundles G0238 as redundant/mutually exclusive to 97014. G0238 is a HCPCS code listing electrical stimulation service and 97014 is a procedure code that is for electrical stimulation. So both of these codes are state the same text but are from different National Coding structures. Therefore, if G0238 is submitted with 97014—only 97014 reimburse.

There are no specific procedure codes describing interferential current stimulation. The following procedure codes might be used: 64550, 97014

The following HCPCS code might also be used:

G0283: Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care.

G0238 (Electrical stimulation {unattended}, to one or more areas for indication(s) other than wound care, as part of a therapy plan of care) bundles with 97014 (Application of a modality to one or more areas: electrical stimulation (unattended})

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