2025 CPT code 20974
(Active) Effective Date: N/A Surgery - Other Procedures on the Musculoskeletal System Feed
Electrical stimulation to aid bone healing; noninvasive (nonoperative).
Modifiers may be applicable in certain situations. For example, modifier 76 may be appended for a repeat procedure by the same physician and modifier 54 may be added if the physician performing the initial service does not perform the subsequent services.Other modifiers may apply depending on the specific payer guidelines.
Medical necessity must be established for the use of electrical stimulation. This typically includes documented evidence of delayed union, nonunion, or high risk of nonunion of a fracture. Payer-specific guidelines should be consulted for coverage criteria.
The physician or other qualified healthcare professional applies the electrical bone growth stimulator to the patient. They determine the appropriate placement of electrodes and settings of the device to administer electrical stimulation to encourage bone healing. The healthcare professional monitors the patient's bone healing progress and device function.
In simple words: The doctor places a device on your skin near the broken bone. This device uses electrical impulses to help the bone heal faster. You wear the device outside of your body.
This code represents the application of a non-invasive electrical bone growth stimulator to aid in the healing of a fracture.The device is external and uses electrical impulses to promote bone growth. It's important to distinguish this from the invasive procedure (20975) where a device is surgically implanted.
Example 1: A patient with a nonunion fracture of the tibia, where the bone has not healed properly after initial treatment, receives noninvasive electrical stimulation to promote bone growth., A patient with a delayed union fracture of the femur, where the bone is healing slower than expected, receives noninvasive electrical stimulation., A patient at high risk of nonunion after a fracture, due to factors like diabetes or smoking, receives noninvasive electrical stimulation as a preventative measure.
Documentation should include the type of fracture, location of fracture, date of fracture, evidence of delayed or non-union (e.g., x-rays, bone scans), and medical necessity for the use of electrical stimulation. Documentation confirming the application of the device by the providing physician is crucial for billing purposes. If a manufacturer’s representative or other personnel perform the setup, the physician may not bill for this service.
** It is important to check with individual payers for specific coverage policies regarding electrical bone growth stimulation.
- Payment Status: Active
- Specialties:Orthopedic Surgery, Podiatry, Physical Medicine and Rehabilitation, potentially other specialties involved in fracture care.
- Place of Service:Office, Outpatient Hospital, Inpatient Hospital (if provided during an inpatient stay for another reason), potentially other places of service.