Wiki Moxibustion with Acupuncture - Modifier 22, Yes or No?

[jonique.dietzen]

Hello, I need some help with billing acupuncture treatment with moxibustion.

What is moxibustion you ask? It is when the acupuncturist uses mugwort to heat the needle or are of insertion for the acupuncture treatment.

Moxibustion is considered incidental to acupuncture treatment and cannot be billed separately but it does take a significant amount of extra effort to perform.
Per my provider "Moxibustion definitely requires more one on one time with the patient. If I place a needle in one acupuncture point, that takes a couple of seconds to do, max. If I do moxibustion on one point, that can take several minutes of direct time with the patient, staying in the room, holding the moxibustion stick. There is also the added time of lighting the moxibustion stick (which actually can take a while) and preparing the equipment."
"Holding a moxibustion stick near a patient's skin for 20 minutes is not terribly complicated or hard work, but it does involve careful attention to the patient and to the possible risk of burning and to delivering an effective treatment."

So now my question, can I bill the acupuncture with moxy services as 97810 and 97811 with modifier 22? There is no rule that state modifier 22 cannot be added to timed services. The guidelines for modifier 22 also state that "An appropriate use of the -22 modifier is when a procedure is truly more complicated that the standard one, although it is not necessarily harder in the usual sense."

What does everyone else think? Modifier 22. Yes or No?

 

[CodingKing]

If i'm not mistaken the code must have a Global period of 00, 10 or 90 days and global does not apply to Acupuncture.

Even if you could, the code requires personal attendance so the fact the practitioner had to be there is not extra, It doesn't take much extra skill to perform this. Time alone is not sufficient to use the modifier and longer session can be billed with additional units as its a per 15 min code unlike most codes that are eligible for modifier 22.

 

[jonique.dietzen]

Yes, you are correct. Modifier 22 does require a global period and the global concept does not apply to acupuncture services. Thank you for pointing that out. With that information we will bill for time alone for these services.

Thanks!