LCD Reference Article Billing and Coding Article

Billing and Coding: Low frequency, non-contact, non-thermal ultrasound

A53773

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.

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General Information

Source Article ID
N/A
Article ID
A53773
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: Low frequency, non-contact, non-thermal ultrasound
Article Type
Billing and Coding
Original Effective Date
10/01/2015
Revision Effective Date
01/01/2024
Revision Ending Date
N/A
Retirement Date
N/A

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim.

Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.

Article Guidance

Article Text

Low frequency, non-contact, non-thermal ultrasound (CPT® code 97610) describes a system employed in wound care that uses continuous low frequency ultrasonic energy to atomize a liquid and deliver continuous low frequency ultrasound to the wound bed. MIST therapy or other similar products are included in the payment for the treatment of the same wound with other active wound care management or wound debridement CPT® codes (97597, 97598, 97602, 97605, 97606).

Response To Comments

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Coding Information

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ICD-10-CM Codes that Support Medical Necessity

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ICD-10-CM Codes that DO NOT Support Medical Necessity

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ICD-10-PCS Codes

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Additional ICD-10 Information

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Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Code Description

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Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

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Other Coding Information

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Coding Table Information

Excluded CPT/HCPCS Codes - Table Format
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Non-Excluded CPT/HCPCS Ended Codes - Table Format
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Revision History Information

Revision History Date Revision History Number Revision History Explanation
01/01/2024 R7

Under CPT/HCPCS Codes Group 1: Codes the description was revised for 97597, 97598, 97605, and 97606. This revision is due to the 2024 Annual/Q1 CPT/HCPCS Code Update and is retroactive effective for dates of service on or after 1/1/24.

02/25/2021 R6

Under CMS National Coverage Policy added regulation Title XVIII of the Social Security Act, §1833(e) and Title XVIII of the Social Security Act, §1862(a)(1)(A).

01/01/2020 R5

Under Article Title revised the title from Low frequency, non-contact, non-thermal ultrasound (CPT code 97610) to Billing and Coding: Low frequency, non-contact, non-thermal ultrasound. Under CPT/HCPCS Codes the code description was revised for CPT® code 97605. This revision is being made due to the Annual CPT®/HCPCS update and becomes effective on 1/1/20.

01/29/2018 R4 The Jurisdiction "J" Part A Contracts for Alabama (10111), Georgia (10211) and Tennessee (10311) are now being serviced by Palmetto GBA. The notice period for this article begins on 12/14/17 and ends on 01/28/18. Effective 01/29/18, these three contract numbers are being added to this article. No coverage, coding or other substantive changes (beyond the addition of the 3 Part A contract numbers) have been completed in this revision.
01/01/2017 R3 Under CPT/HCPCS Codes the description for CPT code 97602 was revised. This revision is due to the 2017 Annual CPT/HCPCS Update and becomes effective 1/1/17.
10/01/2015 R2 Under Article Text deleted CPT codes 11042-11047 as CPT code 97610 should not be reported with these debridement codes. The second sentence was reworded. Under CPT/HCPCS Codes deleted CPT codes 11042, 11043, 11044, 11045, 11046, and 11047.
10/01/2015 R1 Under CPT/HCPCS Codes the description was revised for 97605 and 97606. This revision was due to the 2015 Annual CPT/HCPCS update.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related National Coverage Documents
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SAD Process URL 2
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Public Versions
Updated On Effective Dates Status
01/12/2024 01/01/2024 - N/A Currently in Effect You are here
02/16/2021 02/25/2021 - 12/31/2023 Superseded View
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