2025 CPT code 0101T
(Active) Effective Date: N/A Category III Codes > Various Services - Category III Codes Feed
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified.
Modifiers such as 52 (Reduced Services), 73 (Discontinued Procedure Prior to Anesthesia), 74 (Discontinued Procedure After Anesthesia), etc. may be applicable depending on the specific circumstances of the procedure.
Medical necessity must be established by documenting failed conservative treatments and persistent pain or functional limitations. The documentation should support the use of extracorporeal shock wave therapy as a medically appropriate intervention.
The provider delivers high-pressure sound waves to the affected body area. They identify and mark the most sensitive area, apply conductive gel, place the shock head over the location, and generate power pulses, increasing power incrementally until the maximum level is reached.
In simple words: The provider applies a shock wave to treat a painful musculoskeletal area at a location other than those identified by another CPT® code.This procedure stimulates healing by breaking up calcium deposits or causing an anti-inflammatory response.
Extracorporeal shock wave involving musculoskeletal system, not otherwise specified, high energy.(For extracorporeal shock wave therapy involving integumentary system not otherwise specified, see 0512T, 0513T) (Do not report 0101T in conjunction 0512T, 0513T, when treating same area)
Example 1: A patient presents with chronic plantar fasciitis unresponsive to conservative treatment. The physician uses 0101T to deliver shock waves to the affected area of the foot., A patient experiences pain in the shoulder due to calcific tendinosis. 0101T is used to target the calcium deposits and promote healing., A patient with a bone spur in the foot experiences significant pain. The physician utilizes 0101T to break up the bone spur and alleviate the discomfort.
Documentation should include the diagnosis, the specific musculoskeletal area treated, the number of shocks delivered, the energy level used, and the patient's response to the treatment.
** Category III codes are temporary and used for data collection. They do not guarantee reimbursement. Use of Category III code does not imply agreement on safety or efficacy.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Specialties:Pain Management, Orthopedics, Sports Medicine, Podiatry
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center