2025 HCPCS code G0281
(Active) Effective Date: N/A Revision Date: N/A Therapeutic Procedure - Electrical Stimulation Miscellaneous Diagnostic and Therapeutic Services Feed
Unattended electrical stimulation for chronic stage III and IV pressure ulcers, arterial, diabetic, and venous stasis ulcers.
Modifiers may apply depending on the circumstances of service. Consult payer-specific guidelines for applicable modifiers.
Medical necessity is established when standard wound care has been ineffective for at least 30 days.The wound must be a chronic stage III or IV pressure ulcer, arterial ulcer, diabetic ulcer, or venous stasis ulcer. Regular evaluation by a physician is required to monitor progress and determine continued treatment appropriateness.
The provider (physician or therapist) is responsible for assessing the wound, determining the appropriateness of electrical stimulation, applying the electrodes, monitoring the patient's response, and documenting the treatment plan and progress. Regular physician evaluation is required at least every 30 days.
- Miscellaneous Diagnostic and Therapeutic Services
- G0008-G9987 > Miscellaneous Diagnostic and Therapeutic Services
In simple words: This code covers using a special machine to send a mild electric current to sores (ulcers) that haven't healed after trying other treatments for a month. This helps improve blood flow and speeds up healing.
G0281 describes unattended electrical stimulation applied to one or more areas for treating chronic stage III and IV pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers that haven't shown improvement after at least 30 days of conventional care.This is provided as part of a therapy plan of care. The provider uses a wet electrode pad to administer an electric current, causing muscle contractions and improving blood supply to the affected area, promoting healing.
Example 1: A patient with a stage IV pressure ulcer that hasn't responded to standard wound care after 35 days receives unattended electrical stimulation as part of a comprehensive wound care plan. The treatment is administered by a physical therapist., A diabetic patient with a chronic foot ulcer unresponsive to standard treatments for 40 days undergoes unattended electrical stimulation under the supervision of a physician. The treatment is administered at an outpatient rehabilitation facility., A patient with an arterial ulcer in the lower leg that has not responded to treatment for 30 days is treated with electrical stimulation at a skilled nursing facility under the direction of the physician.
* Detailed wound assessment (size, depth, type, stage)* Documentation of prior treatments and their duration* Photographic or drawing documentation of the wound* Treatment plan specifying parameters for electrical stimulation* Frequency and duration of sessions* Progress notes with objective measurements of wound healing* Physician's orders and evaluation notes, especially after 30 days
** Coverage of G0281 is subject to payer-specific policies and medical necessity.Electrode costs are included in the code.This code is specifically for unattended electrical stimulation.
- Revenue Code: Dependent on the place of service. Examples include 12X (Hospital Inpatient Part B), 13X (Hospital Outpatient), 22X (Skilled Nursing Facility), 23X (Skilled Nursing Facility Outpatient), 71X (Rural Health Clinics), 73X (Federally Qualified Health Clinics), 74X (Outpatient Rehabilitation Facility), 75X (Comprehensive Outpatient Rehabilitation Facility), 85X (Critical Access Hospitals).
- RVU: Not specified in provided sources.RVUs will vary based on location and payer.
- Global Days: Not specified in the provided sources.
- Payment Status: Active, but coverage is dependent on medical necessity and payer policies.
- Modifier TC rule: Not applicable, as this is an unattended modality.
- Fee Schedule: Not available in provided data.
- Specialties:Wound care, physical therapy, podiatry
- Place of Service:Hospital Inpatient, Hospital Outpatient, Skilled Nursing Facility, Outpatient Rehabilitation Facility, Rural Health Clinic, Federally Qualified Health Center, Critical Access Hospital