For years, the correct coding of dry needling, also known as trigger point needling, was a subject of confusion because payers had different coding policies regarding this practice. As of January 1, 2020, the AMA added new non-time-based CPT codes describing this service. They are located in the Surgery section of the CPT code book in the “Procedures on the Musculoskeletal System” section.

By including these services in the musculoskeletal section, it technically opens the door for different types of healthcare providers to perform these services. However, there are some state laws which specifically state that dry needling can only be performed by a licensed acupuncturist. For example: Texas law (as of the time of this article), states that any needling, including dry needling, by a chiropractor is not allowed unless they have an acupuncture accreditation.

As with any coding changes, payer policies may take some time to catch up to these revisions. In some cases (like the example from Texas law above), unless there are changes in the law, the new codes won't make any difference in your ability to either perform or report these services.

One final important reminder is about payer coverage. At the time of this publication, many payer policies stated that this service was noncovered. If the payer does not cover the service, be sure that the patient understands that this is not a covered service and be sure they complete the appropriate form(s). For example, Medicare requires an ABN for statutorily noncovered services.