Medical Policy Notification for CPT 97032, 97014 and G0283

Jan. 17, 2018


This notice advises that as of Oct 15, 2017, claims for commercial policies for CPT 97032, 97014 and G0283 will be denied as Experimental/Investigational in accordance with existing BCBSMT Medical Policies. Commercial policies include fully insured, ASO group and retail policies within the Blue Focus POS, Blue Preferred PPO (excluding FEP), Blue Options, and the Managed Care Network.

Sympathetic Therapy MED201.043
Pelvic Floor Stimulation (PFS) as a Treatment of Urinary or Fecal Incontinence DME101.037
Interferential Current Stimulation MED201.041
Temporomandibular Joint (TMJ) Disorders (TMJD) SUR705.010
Electrical Stimulation for the Treatment of Arthritis MED201.042
Surface Electrical Stimulation MED201.026
Transcutaneous Electrical Stimulation (TENS) and Modulation (TEMPR) MED201.040
Physical Therapy (PT) and Occupational Therapy (OT) Services THE803.010

BCBSMT reviews medical policies on an annual basis or sooner based on updated literature. Since their respective publications, BCBSMT Medical Policy has considered the services for electrical stimulation as Experimental/Investigational. BCBSMT will not seek to recover compensation previously paid for these services. Provider appeals rights are available and are described in the Provider Manual.

If you need additional information about this notification, please contact your Provider Network Consultant.