CPT Code 97014: Application of a Modality to One or More Areas; Electrical Stimulation (Unattended) - Chirotouch
June 22, 2023 by ChiroTouch Team Article Coding

In this quick-reference guide to CPT code 97014, we answer frequently asked questions from our community of chiropractors. Follow us for other articles in our ongoing series, courtesy of ChiroTouch, the cloud-based EHR designed specifically for chiropractors. 

NOTE: CPT codes and guidelines can be revised over time. To avoid billing issues, be sure to stay current with annual coding updates and changes to payer guidelines.

About CPT Code 97014: Application of a Modality to One or More Areas; Electrical Stimulation (Unattended)

CPT code 97014 refers to the application of a modality to one or more areas, specifically electrical stimulation, which is unattended. This procedure involves the use of electrical stimulation devices to apply therapeutic electrical currents to targeted areas of the body. Unattended means that the patient does not require constant supervision during the application of the modality.

Here’s what chiropractors need to know about using CPT code 97014.

Category or Type of Service

CPT code 97014 falls under the category of Physical Medicine and Rehabilitation services. It specifically pertains to the application of modalities, which are therapeutic procedures used to treat various musculoskeletal conditions.

Billing Interval

This code is typically billed per unit or session. This can be confusing because attended electrical stimulation treatment is billed differently. When the treatment is attended, it must be coded 97032 and billed in 15-minute increments.

When Should Chiropractors Use This Code?

Chiropractors should use CPT code 97014 for the application of unattended electrical stimulation to treat established patients. Here are the key criteria for using this code:

  • There must be a clear medical reason for using electrical stimulation as part of the patient’s treatment plan.
  • The treatment session must be unattended.

When Should Chiropractors Not Use This Code?

  • Chiropractors should avoid using CPT code 97014 if the patient requires continuous supervision or assistance during the electrical stimulation session. In those situations, use CPT code 97032.
  • It may not be advisable for chiropractors to use this code for new patients. While there are no explicit rules against it, many insurance providers require an established treatment history and demonstrated need for this treatment, which are difficult to establish on a first visit.

Which Modifiers Can Be Used With CPT Code 97014?

The most common modifiers used with CPT code 97014 are:

  • Modifier 59. This modifier indicates that the procedure is distinct and separate from other services performed on the same day.
  • Modifier 25. This is used to indicate that a separately identifiable evaluation and management service was performed on the same day as the procedure.
  • Modifier GP. Some payers (like UnitedHealthcare) require this modifier for services provided by chiropractors that fall within the scope of physical therapy. In rare cases, Medicare may cover specific chiropractic services when accompanied by the GP modifier, but such coverage is very limited.

What Are the Billing Guidelines and Documentation Requirements Specific to This Code?

When billing for CPT code 97014, adhere to the following guidelines:

  • Documentation of time. Clearly document the duration of the electrical stimulation session to support billing for the appropriate number of units.
  • Treatment area. Specify the areas of the body where electrical stimulation was applied.
  • Patient supervision. Document that the patient did not require continuous supervision during the procedure.
  • Medical necessity. Provide the rationale for the use of electrical stimulation based on the patient’s condition and treatment plan.

What Are Common Mistakes Made Specific to CPT code 97014?

Some common mistakes associated with CPT code 97014 include:

  • Incorrect documentation. Accurately document the duration of the treatment session.
  • Billing for attended stimulation. If you have to supervise the procedure, it should be coded 97032 and billed in 15-minute increments rather than per unit or session.
  • Lack of medical necessity. Include sufficient documentation to support the medical necessity of the procedure.
  • Failure to use modifiers. Be sure to apply appropriate modifiers when needed.
  • Inaccurate coding for Medicare patients. Medicare uses the code G0283 for electrical stimulation.

What Are Potential Audit Triggers Specific to This CPT Code?

Audit triggers related to CPT code 97014 may include:

  • Inconsistent billing patterns. Sudden increases in the use of this code without adequate justification are a common audit flag.
  • Documentation discrepancies. Discrepancies between documented time and billed units are particular problems, but any discrepancies can draw audit attention.
  • Poorly demonstrated medical necessity. If the documentation doesn’t back up the decision, auditors take notice.

This code is a common auditing red flag. For a more detailed explanation, read The 97014 CPT Code: Understanding This Audit Trigger.

What Can I Do to Improve the Accuracy and Efficiency of My Practice’s Billing and Coding Processes?

To enhance billing and coding processes related to CPT code 97014, consider the following steps:

  • Ensure staff are trained on proper documentation and coding procedures.
  • Conduct regular self-audits and check to identify and address coding errors.
  • Stay current with changes in coding regulations and payer policies.
  • Consider switching to modern, integrated chiropractic EHR and practice management software.

Use ChiroTouch and CT Payments To Make Coding and Billing Easier

Integrating payment processing into your chiropractic practice with ChiroTouch and CT Payments helps you spend less time dealing with billing and more time with your patients. CT Payments offers modern payment options your patients know and prefer, like credit cards, Apple Pay, Google Pay, and online payments, so you can cater to your patient’s preferences while simplifying payment processes.

CT Payments not only saves staff time and effort but also gives your patients convenient features such as storing credit cards for future payments and scheduling recurring transactions. CT Payments facilitates better cash flow, efficiency, and patient experiences, contributing significantly to the success of your practice.

Read Chiropractic Billing and Payments: One Screen Does It All to learn more about CT Payments.

To see firsthand how ChiroTouch can streamline your billing processes, book a demo today!

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