99204 (initial vist) and 97813 (acu with some stim)

WJJ Acupuncture, P.C. v Geico Ins. Co., 2011 NY Slip Op 52377(U)(App. Term 2d Dept. 2011)

“Moreover, defendant demonstrated that it had fully paid plaintiff for the services billed under CPT code 97813 in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d, 11th & 13th Jud Dists 2009]). Since, with the exception of plaintiff’s claim of $114 for the initial acupuncture visit on October 26, 2005, defendant fully paid the amount to which plaintiff was entitled for acupuncture services rendered by plaintiff’s licensed acupuncturist from October 26, 2005 through January 19, 2006, so much of defendant’s cross motion for summary judgment seeking to dismiss the complaint as to these claims is granted.

Defendant did not proffer any evidence or argument to warrant the dismissal of plaintiff’s claim of $114 for the initial acupuncture visit on October 26, 2005, billed under CPT code 99204 (cf. Rogy Med., P.C. v Mercury Cas. Co., 23 Misc 3d 132[A], 2009 NY Slip Op 50732[U] [App Term, 2d, 11th & 13th Jud Dists 2009]).”

You know I lost Rogy on the same ground that everyone loses the initial acupuncture visit.  Why is there a “C.F.” cite?  It should be a “see” cite.

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