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Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment modality that utilizes high-energy acoustic waves to facilitate the healing of integumentary wounds. This therapy is particularly beneficial for chronic wounds, which may include venous leg ulcers, diabetic foot ulcers, pressure ulcers, and arterial insufficiency ulcers. Additionally, ESWT can be applied to acute conditions such as burns, postsurgical wounds, and post-traumatic wounds. The procedure involves the delivery of a sequence of biphasic acoustic pulses through a transducer device, which generates transient pressure disturbances in a three-dimensional space. This increase in pressure is instrumental in stimulating neovascularization, a process that promotes the formation of new blood vessels, thereby enhancing blood flow to the affected area. Furthermore, ESWT is known to reduce inflammation and alleviate nociceptive pain, contributing to improved patient comfort and recovery. However, it is important to note that complications may arise from the procedure, including bleeding, petechiae, hematoma or seroma formation, and localized pain. The CPT® Code 0512T specifically reports the application of extracorporeal shock wave therapy for the initial treatment of integumentary wounds, which includes the necessary topical application and dressing care. For subsequent treatments of additional wounds, CPT® Code 0513T is utilized.
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Extracorporeal shock wave therapy (ESWT) is indicated for various chronic and acute wound conditions. The following are the specific indications for which this procedure may be performed:
The procedure for extracorporeal shock wave therapy (ESWT) involves several key steps that ensure effective treatment of integumentary wounds. The following outlines the procedural steps:
Following the extracorporeal shock wave therapy, patients may experience some localized discomfort, which is typically mild and temporary. It is essential for patients to follow the post-procedure care instructions provided by their healthcare provider, which may include keeping the treated area clean and dry, changing dressings as directed, and monitoring for any signs of complications such as increased pain, swelling, or unusual discharge. Patients are often advised to avoid strenuous activities that may stress the wound site during the initial recovery period. Follow-up appointments may be scheduled to assess the healing progress and determine if additional treatments are necessary.
| Short Descr | ESW INTEG WND HLG 1ST WND | Medium Descr | ESW INTEGUMENTARY WOUND HEALING INITIAL WOUND | Long Descr | Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound | Status Code | Carriers Price the Code | Global Days | YYY - Carrier Determines Whether Global Concept Applies | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 0513T | Add-on Code Resequenced Code MPFS Status: Carrier Priced APC N ASC N1 Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; each additional wound (List separately in addition to code for primary procedure) |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GW | Service not related to the hospice patient's terminal condition | KX | Requirements specified in the medical policy have been met | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | T9 | Right foot, fifth digit | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2022-01-01 | Changed | Code description changed. |
| 2019-01-01 | Added | Added |
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