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.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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