A student stands over a patient, needle poised. They have a “perfect” prescription: a textbook combination of points harvested from a lecture slide on chronic lower back pain. But as the needle meets the skin, the student hesitates - the symptom of a quiet habit that has taken hold of our profession. We routinely say we “prescribe” points. It sounds efficient. It echoes the authority of biomedical culture and fits neatly into the insurance field. But vocabulary is never neutral; repeated long enough, it dictates behavior.
New Codes for the New Year
Q I have been billing insurance for some time now, and I am aware that codes for diagnosis and procedures are updated each year. Are there any of which you are aware for 2009 that are applicable to acupuncture providers?
A I am very excited to note that last two major changes to diagnosis codes (2007 and 2009) included new codes for the diagnosis of pain and headaches. For 2009, there are 35 new and updated ICD-9 codes for headaches and three new CPT procedure codes for injections (note that there are states that do allow a certified or licensed acupuncturist to perform injections). The diagnosis update is as follows:
| 96372 | Therapeutic, prophylactic or diagnostic injection (specify substance or drug); subcutaneous or intramuscular (replaces 90772) |
| 96373 | Therapeutic, prophylactic or diagnostic injection (specify substance or drug); intra-arterial (replaces 90773) |
| 96379 | Unlisted therapeutic, prophylactic or diagnostic intravenous or intra-arterial injection or infusion (replaces 90779) |
| 307.80 | Psychogenic pain, unspecified | 339.44 | Other complicated headache syndrome |
| 307.89 | Pain disorder related to psychological factors, other | 339.81 | Hypnic headache |
| 339.00 | Cluster headache syndrome, unspecified | 339.82 | Headache associated with sexual activity |
| 339.01 | Episodic cluster headache | 339.83 | Primary cough headache |
| 339.03 | Episodic paroxysmal hemicranias | 339.84 | Primary exertional headache |
| 339.04 | Chronic paroxysmal hemicranias | 339.85 | Primary stabbing headache |
| 339.05 | Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing | 339.89 | Other specified headache syndromes |
| 339.09 | Other trigeminal autonomic cephalgias | 346.00 | Migraine with aura |
| 339.10 | Tensio-type headache, unspecified | 346.10 | Migraine without aura |
| 339.11 | Episodic tension-type headache | 346.20 | Variants of migraine |
| 339.12 | Chronic tension-type headache | 346.30 | Hemiplegic migraine |
| 339.20 | Posttraumatic headache, unspecified | 346.40 | Menstrual migraine |
| 339.21 | Acute posttraumatic headache | 346.50 | Persistent migraine aura without cerebral infarction |
| 339.22 | Chronic posttraumatic headache | 346.60 | Persistent migraine aura with cerebral infarction |
| 339.30 | Drug-induced headache, not elsewhere classified | 346.70 | Chronic migraine with aura |
| 339.41 | Hemicrania continua | 346.80 | Other forms of migraine |
| 339.42 | New daily persistent headache | 346.90 | Migraine unspecified |
| 339.43 | Primary thunderclap headache | ||
For more specific information on the ICD-9, you can visit the Center for Disease Control's National Center for Health Statistics Web site at www.cdc.gov/nchs/datawh/ftpserv/ftpicd9/ftpicd9.htm#guidelines.