CPT® Code 97811 is used to report acupuncture services involving re-insertion of needles, lasting an additional 15 minutes beyond the initial treatment. It is always billed in conjunction with CPT 97810, which covers the first 15 minutes of acupuncture without electrical stimulation.
Overview
Acupuncture involves the insertion of thin needles into specific anatomical points to treat various conditions, from chronic pain to stress-related symptoms and internal disorders. CPT 97811 specifically covers subsequent 15-minute increments where needles are re-inserted, and the practitioner is in constant, personal contact with the patient.
This code may be used for treatment of conditions such as:
- Back or neck pain
- Headaches and migraines
- Anxiety and depression
- Digestive and menstrual disorders
- Musculoskeletal dysfunction
Typical Patient Description
A patient with chronic low back pain presents for an acupuncture session. The provider performs an initial 15-minute treatment under CPT 97810, then removes and re-inserts needles in different locations for an additional 15-minute session, addressing new pain points and stimulating fresh meridian pathways. CPT 97811 is used to bill for this additional, continuous care.
Care Components
- Personal, one-on-one care with the patient throughout the session
- Needles are removed and reinserted in new points during the additional time
- At least 15 additional minutes of face-to-face time with the patient
- Includes:
- Evaluation of point effectiveness
- Re-assessment of patient’s condition
- Adjustment of treatment plan
Billing Considerations
- CPT 97811 is an add-on code: Must be billed with 97810; it cannot be used alone.
- Time-based: A full 15-minute interval must be completed and documented.
- Multiple units allowed: For longer sessions, additional 97811 units may be used (e.g., two units = 30 minutes of follow-up acupuncture with re-insertion).
- No electrical stimulation: If electroacupuncture is used, codes 97813/97814 should be billed instead.
- Documentation must support:
- Total time of face-to-face contact
- Description of needle re-insertion
- Response and tolerance to treatment
Using CPT 97811 in OptiMantra
OptiMantra offers a streamlined experience for acupuncture practices, helping to ensure accurate documentation and billing of 97811:
- Acupuncture-specific templates: Designed to record needling sites, insertion methods, time spent, and patient response.
- Time tracking support: Helps verify proper documentation of treatment duration for both 97810 and 97811.
- Multiple unit billing: Easily add multiple 97811 units to reflect longer sessions while remaining payer-compliant.
- Treatment progress logs: Track response to therapy over time, allowing clinicians to justify continued treatment and show efficacy.
With OptiMantra, practitioners can focus on delivering effective acupuncture care while ensuring their services are well-documented and properly reimbursed.
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