MedLightPro.com
Insurance Reimbursement
Insurance Reimbursement and Billing
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The following are the most common in-office codes used by practitioners of laser and/or LED
therapy.
In-office physical modality codes:
97026: Infrared light therapy
97032: Attended Electrical Stimulation
This is a code that many practitioners modify for laser and LED therapy. Although the CPT code will
stay the same, 97032, the description should be changed to accurately reflect the service
performed. Below are some common ways that we have seen this code utilized by physicians and
therapists:
97032: Attended Electrical-Photonic Stimulation or
97032: Attended Electrotherapy/lR
97139: Unlisted Therapeutic Procedure
This code is for a therapeutic procedure meaning that the doctor must have one-on-one contact
with the patient. Billing might look like:
97139: Electrical-Photonic Stimulation: Constant attendance
We are not recommending any particular codes nor advising you on billing issues.
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Reimbursement of device purchase/rental - Prescription for use of home therapy
device:
Healthcare practitioners have reported some success with insurance company reimbursement for
purchase of the MedLight 360 Pro when prescribed by a physician (with detailed explanation) for
home pain management care.
NOTE:
Reimbursement can vary significantly from company to company and even with in the same plans
from individual to individual depending on condition, diagnosis, etc. We recommend selling the
MedLight 630Pro on a CASH basis to the patient with the promise of reimbursement/credit to the
patient if and when the insurance company provides payment (sometimes they do, sometimes they
don't). It is not recommended to rely on insurance reimbursement as the primary means of sale,
the MedLight 630Pro is a bargain at the cash price of $199.95 and we have had no trouble selling
them to patients without any insurance reimbursement.
Mail the HCFA and 3 page medical necessity/explanation in one envelope:
Sample coding:
For major medical insurance: E0202-NU (purchase) or E0202-RR (rental) Phototherapy pain therapy
device with explanation and prescription.
For Medicare: E1399 Durable Medical equipment with explanation and prescription.
Medical Necessity Letter and Explanation for prescription purchase of device for home use
Sample EoBs demonstrating Reimbursement (posting more examples as they are received):
Cigna (E0202-NU)
Anthem BC/BS (E0202-RR)
Humana
United Health Care
Aetna
-------------------------------------------------------------------------------------------------------------------------------
The following are the most common in-office codes used by practitioners of laser and/or LED
therapy.
In-office physical modality codes:
97026: Infrared light therapy
97032: Attended Electrical Stimulation
This is a code that many practitioners modify for laser and LED therapy. Although the CPT code will
stay the same, 97032, the description should be changed to accurately reflect the service
performed. Below are some common ways that we have seen this code utilized by physicians and
therapists:
97032: Attended Electrical-Photonic Stimulation or
97032: Attended Electrotherapy/lR
97139: Unlisted Therapeutic Procedure
This code is for a therapeutic procedure meaning that the doctor must have one-on-one contact
with the patient. Billing might look like:
97139: Electrical-Photonic Stimulation: Constant attendance
We are not recommending any particular codes nor advising you on billing issues.
-------------------------------------------------------------------------------------------------------------------------------
Reimbursement of device purchase/rental - Prescription for use of home therapy
device:
Healthcare practitioners have reported some success with insurance company reimbursement for
purchase of the MedLight 360 Pro when prescribed by a physician (with detailed explanation) for
home pain management care.
NOTE:
Reimbursement can vary significantly from company to company and even with in the same plans
from individual to individual depending on condition, diagnosis, etc. We recommend selling the
MedLight 630Pro on a CASH basis to the patient with the promise of reimbursement/credit to the
patient if and when the insurance company provides payment (sometimes they do, sometimes they
don't). It is not recommended to rely on insurance reimbursement as the primary means of sale,
the MedLight 630Pro is a bargain at the cash price of $199.95 and we have had no trouble selling
them to patients without any insurance reimbursement.
Mail the HCFA and 3 page medical necessity/explanation in one envelope:
Sample coding:
For major medical insurance: E0202-NU (purchase) or E0202-RR (rental) Phototherapy pain therapy
device with explanation and prescription.
For Medicare: E1399 Durable Medical equipment with explanation and prescription.
Medical Necessity Letter and Explanation for prescription purchase of device for home use
Sample EoBs demonstrating Reimbursement (posting more examples as they are received):
Cigna (E0202-NU)
Anthem BC/BS (E0202-RR)
Humana
United Health Care
Aetna
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