Billing 97033, Iontophoresis, to Medicare

[Carol.Dohmen]

We have found that 97033, Iontophoresis, is non-covered service by MCR they consider it experimental only. Has anyone had any luck with payment on this procedure with any other coding, modifier or LCD with medically necessary diagnoses?

Is the best route to have patient sign an ABN and collect after denial?

 

[CodingKing]

I don't know about for regular Medicare but where I work for both Commercial and our Medicare Advantage plans we only cover it for one reason.

Tap water Iontophoresis is medically necessary for the treatment of primary focal palmoplantar hyperhidrosis that has not responded to standard therapy, including 15% to 25% aluminum chloride.

Here's a Link from Noridian stating its not covered

https://www.noridianmedicare.com/provider/updates/docs/non-covered_therapy_services.pdf

Heres an :LCD from the East that says only covered for hyperhidrosis if standard therapy has failed

http://apps.ngsmedicare.com/lcd/LCD_L26884.htm

 

[kivbar16]

We have found that 97033, Iontophoresis, is non-covered service by MCR they consider it experimental only. Has anyone had any luck with payment on this procedure with any other coding, modifier or LCD with medically necessary diagnoses?

Is the best route to have patient sign an ABN and collect after denial?

Yes, best practice would be to have the patient sign an ABN. As stated above, the only covered dx for Ionto (Medicare plans) is hyperhidrosis.