Electrical Stimulation Therapyplays a significant role in physical therapy. The use of electrical stimulation devices is rapidly expanding in many hospitals. According to a 2023 market research, hospitals were the leading users of electrical stimulation devices, capturing 58% of the market share. These devices are primarily used for pain management, neurological care, and rehabilitation.
But how do providers collect reimbursements from insurance payers for the use of such devices in physical therapies? The answer is electrical stimulation therapy codes like CPT code 97032.
This blog will provide you with insights into the correct billing of this code.
CPT Code 97032 – Description
CPT code 97032 refers to an electrical stimulation therapy, which is a physical therapy procedure involving the manual application of electrical stimulation to treat muscle spasms, pain, and other conditions.
Electrical stimulation therapy treats pain and other muscle-related illnesses by stimulating the muscles with electricity. The therapist covers the afflicted muscle regions with electrodes. These muscles are then contracted and expanded by passing an electric current of varying intensities through the electrode pads. It promotes improved blood circulation, pain relief, enhanced task performance, and the restoration of normal muscle strength.
97032 is a time-based code that requires continuous, direct provider attendance. It is billed in 15-minute increments.
Scenarios Where CPT Code 97032 is Applicable
The following are typical therapeutic scenarios in which CPT code 97032 should be used:
Post-Surgical Muscle Strengthening
Suppose a 60-year-old man underwent a total knee replacement surgery. Post-surgery, he experiences muscle pain and swelling around the knee. He visits a therapist, who manually applies electrical stimulation to activate specific muscle groups of his knee. The therapist closely monitors muscle contraction, adjusts intensity levels, and ensures proper electrode placement to promote effective muscle re-education and functional recovery. He may apply CPT code 97032 to bill his services.
Chronic Muscle Pain
Let’s imagine that a fifty-year-old woman has limited mobility as a result of osteoarthritis. She visits a physical therapist who uses manual electrical stimulation to increase blood circulation, relax tense muscles, and reduce pain signals. Throughout the session, the therapist actively adjusts the stimulation settings to the patient’s pain threshold and tolerance. Due to his consistent attendance during the therapy, he should use CPT code 97032 to bill for his services.
Applicable Modifiers for CPT Code 97032
The following are some applicable modifiers that may be applied to CPT code 97032. However, their use must be supported with adequate documentation.
Modifier 59
Modifier 59 can be applied to CPT code 97032 to indicate that the service was a distinct procedural service from other services performed on the same day. It is used to bypass NCCI edits when the documentation supports that the procedures are separate and distinct. The services must have been rendered in separate patient encounters, or different providers, or on different anatomical sites.
Modifier GP
You must apply the GP modifier with CPT code 97032 to signify that the electrical stimulation therapy was performed under a physical therapy plan of care. GP modifier is required by many payers, including Medicare and prominent private insurers like UnitedHealthcare (UHC) and BlueCross BlueShield (BCBS), to indicate it is a physical therapy service.
CPT Code 97032 – Billing & Reimbursement Guidelines
Lastly, here are some billing and reimbursement guidelines for CPT code 97032.
Ensure Correct Application of 97032
You can use CPT code 97032 for manual application of electrical stimulation to improve muscle function or reduce pain. However, since it is a time-based code, you cannot bill this code for unattended electrical stimulation (manual). These codes necessitate continuous, one-on-one interaction between a trained specialist and patient. Do not apply this code for unattended electrical stimulation or when the procedure is not medically necessary.
Provide the Necessary Paperwork
Your therapy services must be supported by documentation and the patient’s comprehensive medical record to demonstrate the medical need for each session. The payer has the right to withhold your payment if you don’t attach sufficient information and proof with the claim form.
The following details, which must be included in this thorough documentation to support the procedure’s functional purpose and medical need, will help you avoid the risk of denial.
- Functional goal
- Procedure description
- Clinical rationale
- Patient response
- Type of modality
- Area of application
- Setting and frequency
- Service’s start and end time for time-based coding
Final Word
CPT code 97032 is used when a physical therapist or other licensed healthcare provider applies electrical stimulation (manual) to one or more areas on the patient’s body for fifteen minutes. We hope that the billing of this code is clear after learning about the scenarios, applicable modifiers, and billing guidelines discussed above.
However, if this blog does not cover the answers to your problems, we highly recommend that you use expert physical therapy billing services to submit clean claims before denials hurt your practice’s financial performance.
