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Aupuncture
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97810
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97811
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97811
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97813
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97814
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97814
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97026
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97139
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Position
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Body Part
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Face/Head/Ear
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Electrical Stimulation
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Body Part
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Mid Back/Chest
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Body Part
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Upper Back/Mid Back/Chest
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Body Part
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Lower Back
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Body Part
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Neck/Arm/Hand/Leg/Foot
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Body Part
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Buttock/Thigh/Hip
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Body Part
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Shoulder/Elbow/Knee/Ankle
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Tolerated Treatment
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Did Not Tolerate Treatment
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Describe Incident
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Acupuncture Consent
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Doctors Signature
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