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Chiropractic Coding & Compliance Alert

Compliance/Reimbursement:
Don't Get Burned: Palmetto GBA's Scalding Audits Screaming a 60 Percent Error Rate
No response to ADRs the top reason for denial. It seems to be raining audits for chiro... Read more
Coding Updates:
Keep Track of LCD Updates This Quarter
Watch for more changes as ICD-10 catches on. As you embrace the ICD-10 sea of change, ... Read more
ICD-10 Update:
Discover Wider Options For Sprain and Strain Coding
Dig in the long descriptors to choose from more than a dozen codes for neck pain You c... Read more
Reader Question:
Number of ABNs Needed for Regular Maintenance Therapy
Question: One of our Medicare patients requires services which will essentially com... Read more
Reader Question:
Fortify Your Documentation to Justify 98942
Question: Our Medicare contractor is auditing claims with 98942. Do you have any su... Read more
Reader Question:
Does a CMT Code Need Modifiers?
Question: What modifier would I report for a patient who had a CMT (98940-98943) fo... Read more
Reader Question:
Fill Box 14 Right the First Time
Question: What are the facts to keep in mind when filling boxes 14 and 15 for a new... Read more
You Be the Coder:
Code It Right for Lumbosacral Pain and Subluxation
Question: A patient comes in with low back pain and the provider diagnoses a sublux... Read more
Reimbursement/Compliance:
OIG Questions $76 Million Payment to Chiropractors in 2013, CMS to Take Action
OIG Questions $76 Million Payment to Chiropractors in 2013, CMS to Take Action Only 2 ... Read more
ICD-10/Reimbursement:
Get a Foothold With the Medicare Recommended Chiropractic Codeset
Here’s how to know the codes Medicare wants you to use. Are you astounded by the... Read more
ICD-10 Update:
Must Know: Revisit Your Understanding of Chiropractic Subluxation Now
Do not go by the index when coding for 739 series. When it comes to coding in ICD-10-C... Read more
Reader Question:
Learn More About the Seventh Character
Question: What are the guidelines for using A, D, or S as a seventh character? Ut... Read more
Reader Question:
Does ICD-10 Offer Codes for Right and Left Aspect of the Spine?
Question: Do we have any options to code the left and right sides for ICD-10 codes ... Read more
Reader Question:
How to Interpret NEC and NOS in ICD-10
Question: I was looking at the ICD-10-CM manual, and I noticed NEC and NOS. I know ... Read more
Reader Question:
Reimbursement to a Non-Par Provider
Question: How does the reimbursement differ when a non-par provider of chiropractic... Read more
Reader Question:
Are You Billing For Maintenance Therapy?
Question: Knowing that Medicare does not pay for maintenance services, how do I fin... Read more
Reader Question:
Master the Medical Necessity Requirements
Question: A chiropractor provided manual manipulation of the spine in treating a co... Read more
Reader Question:
Crack Down Your Covered Chiropractic Services
  Question: What are the covered chiropractic services under Medicare? Flo... Read more
You Be the Coder:
How to Code Subluxation of the Lumbar and Sacral Spine
Question: What diagnosis codes can we submit for a patient who presents with a subl... Read more
Reimbursement:
Get to Know What Other Payers Think About Using ICD-10
Know these 4 empirical facts on ICD-10 preparations and claims processing. Worried abo... Read more
Policy:
Know These 3 Legislative Issues That ACA Salvaged
Score big with ACA’s work on documentation, parity, PPACA, and more. It’s ... Read more
ICD-10 Update:
Decoding the ICD-10 Flexibilities: What the Guidance Does and Does Not Cover
Look forward to disclaimers, status quo, and a new ombudsman. ICD-10 is here, finally... Read more
Reader Question:
Does Medicare Reimburse Multiple Daily Visits?
Question: In this era of accelerated treatment protocols for faster recovery, some ... Read more
Reader Question:
Clear Up the Confusion on X-ray Billing
Question: As a chiropractor, we often need to use diagnostic services such as X-ray... Read more
Reader Question:
Does Medicare Accept Other Words for Spinal Manipulation?
Question: While documenting spinal manipulation treatment for a patient with spinal... Read more
Reader Question:
Make the Most of the New ICD-10 LCDs
Question: How can we access updates to ICD-10 Local Coverage Determinations in the ... Read more
You Be the Coder:
Coding the Second Encounter for a Neck Strain Patient
Question: A patient visits the office for a second time. She has the diagnosis of n... Read more
Compliance/Reimbursement:
OIG Asks a 97 Percent Refund from Third Most Rich DC in California
Save thyself from 3 lethal errors in documentation. Are you too busy with patients, a... Read more
Compliance/Policy:
Using Windows XP May Disrupt Your HIPPA Compliance
Safeguard your PHI from security threats. Did you know that your faithful old companio... Read more
ICD-10 Update:
Usher in October 1 With CMS's Positive Feedback on Claims Testing
Win the battle by setting right the invalid NPIs and ICD-10-CM codes. If your facilit... Read more
Reader Questions:
Know the Documentation Requirements of an Initial Visit
Question: Do we have any guidelines regarding the documentation requirements for an... Read more
Reader Questions:
How to Safely Offer Cash Discounts to Patients
Question: We would like to offer cash discounts but are unsure how to best do this.... Read more
Reader Questions:
Understand the Difference Between Date of Initial Treatment and Date of Injury
Question: What is the difference between the “Date of the Initial Treatment&r... Read more
Reader Questions:
Brush Up on the "X" Character in ICD-10
Question: How do we approach the usage of the “X” placeholder character... Read more
You Be the Coder:
Work Your Way Around 97112 and 97102 Denials
Question: We usually bill 97112 and 97012 in addition to the chiropractic spinal ma... Read more
Reimbursement/Compliance:
Do Not Let the Dual Fee Schedules Plague You
Let the UCR be your guiding light. Do you want to know just how much can you charge yo... Read more
Coding/Reimbursement:
Learn How to String 97140 and CMT Codes Together
Hold on to your dollars with these 2 simple facts. Still facing denials while billing ... Read more
ICD 10 Update:
CMS and AMA Promise to Forego ICD-10 Code Based Denials
Ease off the burden with these 4 concessions that hold good for one year. Breathe easy... Read more
Reader Questions:
How to Get Paid for Functional Testing
Question: To measure “functional improvement” as a yardstick for effica... Read more
Reader Questions:
How Do Chiropractors Code for Fill-In Doctors
Question: I own a small practice myself and had asked someone to look after the ser... Read more
Reader Questions:
When Can Chiropractors Bill 99211?
Question: A patient comes in for a follow-up visit, but no adjustment is performed.... Read more
Reader Questions:
Check With Your LCDs Before You Give Dynamic Thrust
Question: A patient presents with low back pain, and he also reports to be on antic... Read more
You Be the Coder:
Does 739.0 Cover All Lesions of the Head?
Question: We generally use 739.x codes for spinal subluxation. However, can I also ... Read more
Compliance/Reimbursement:
Take Aim at Modifiers and Myths of Advanced Beneficiary Notices
Solve your ABN dilemmas with these 4 tips. Are you one amongst those who often face th... Read more
Auditing:
Brace Yourself as Noridian Medicare Proposes to Audit 98941 Claims
Use these strategies to wade through tough payer scrutiny If you’ve noticed an i... Read more
ICD-10 Update:
Tune in Your Radar to This CMS Advice
Heed these 12 facts that CMS wants you to know about ICD-10. The clock is ticking and ... Read more
Reader Questions:
Determining Which Payer Provides for Co-payment
Question: When we have a patient with both a primary and a secondary insurance, whi... Read more
Reader Questions:
Where to Look for LCDs for ICD-10
Question: Where can we find the Medicare LCDs for ICD-10? Iowa Subscriber Answe... Read more
Reader Questions:
Use Modifier 25 for Distinct Services
Question: The DC evaluates a new patient and performs chiropractic manipulative tre... Read more
Reader Questions:
When Patient Doesn't Understand ABN
Question: We have a patient who was put under maintenance therapy. She was given an... Read more
You Be the Coder:
Can We Code Massage with 97112?
Question: We usually submit 97124 for massage, but we were told to use 97112 instea... Read more
Reimbursement /Policy:
Know What the 2015 MACRA Act Means for DCs
Chiros to receive documentation reeducation and more. The Medicare Access and CHIP Rea... Read more
Compliance:
Be Forewarned With Palmetto's First Quarter Review of Claims Denials
Safeguard your practice with these 4 Medicare tips. Denials are a given for medical pr... Read more
ICD-10 Update:
Put Your ICD-10 Worries Behind You With the Proposed Transition Period
The new bill for ICD TEN Act brings you relief.  As we wait for the impending arr... Read more
Reader Questions:
Modifiers That Help Bill Noncovered Services With ABN
Question: Are the providers required to bill “noncovered” services to M... Read more
Reader Questions:
Is 98943 Reimbursed by Medicare for Chiropractics?
Question: The provider performs CMT to the left shoulder. He also performs CMT of t... Read more
Reader Questions:
Code It Right for CMT to Three Vertebrae
Question: What modifier would I report for a patient who had a CMT (98940-98943) fo... Read more
Reader Questions:
When Can an "Opt out" Provider Treat a Medicare Patient?
Question: When a physician or practitioner opts out of Medicare; can he still get r... Read more
You Be the Coder:
G Code When a Patient Does Not Fill Out the Form
Question: A patient presents for re-evaluation. He is asked to complete an updated ... Read more
Reimbursement/Policy:
Know How the "Final Doc Fix" Saves You From 21 Percent Pay Cuts and More
The new law brings in chiropractic documentation education, new quality-reporting incent... Read more
Policy/Insurance:
Command Insurance Equality the WCA Way
Wisconsin DCs look forward to inclusion, transparency, and more dollars in 2015. Empow... Read more
ICD 10 Update:
Chart Out for the Chiropractic Subluxation Crosswalks
Keep an eye on what the LCDs reveal. There has been significant speculation regarding ... Read more
Reader Questions:
Does a Non-Par Provider Have to Document All the Same?
Question: Do non-par providers have the same documentation requirements as particip... Read more
Reader Questions:
Know Your Codes for Low Back Pain in ICD-10
Question: A patient comes in with low back pain and the provider diagnoses a sublux... Read more
Reader Question:
Heed the Place of Service Requirements for DCs
Question: Are there any specific standards for the place of service that a DC shoul... Read more
Reader Question:
How to Claim a Chiropractic Outpatient Service
Question: How does one go about filing a claim for chiropractic services rendered t... Read more
You Be the Coder:
Know Which G Code to Use for a Missed Pain Assessment
Question: A patient comes to the clinic a few weeks after his scheduled visit with ... Read more
Reimbursement:
Appeal the Right Way to Reverse Your Denied Claims
Is the denial administrative or clinical? Prepare accordingly. You don’t need to... Read more
Compliance:
Slay Your Electronic Privacy Issues With This 6-Point Strategy
Encrypted software can shield you from being a hacker’s feast. Is your facility ... Read more
ICD-10 Update:
Pick Up the Threads and Cast a Net on Your ICD-10 Worries
Boost your preparations with these 5 strategic tips. All set for ICD-10 on October 1? ... Read more
Reader Questions:
Are Medicare Audits for Non Par Providers Too?
Question: Are non par providers not subject to Medicare audits? Texas Subscriber Ans... Read more
Reader Questions:
Are Chiropractors Eligible for Bonus Incentive Programs?
Question: Are chiropractors eligible for bonus incentive programs?  Tennesse... Read more
Reader Questions:
Take Heed of These as the Patient Signs an ABN
Question: The provider notifies the patient regarding a non covered maintenance service.... Read more
Reader Questions:
When Do You Not Submit a Claim to Medicare?
Question: Do I have to submit a claim to Medicare if the beneficiary agrees to pay ... Read more
You Be the Coder:
Know The G Code for Complete Recovery
Question: A patient presents after a series of treatments without reportable pain. ... Read more
E/M & Reimbursement:
Safeguard Your E/M Services Payment for the New Patient
Chime in with the nuances of E/M services coding. Are you facing denial from payers, i... Read more
Accreditation:
Don't Miss Your New Power With Modified Pain Management Standards
Joint Commission includes chiropractic services in the revised EPs for 2015. Services ... Read more
ICD-10 Update:
Expect No Delay in ICD-10 This Time, Says the Congressional Hearing
Enlighten yourself with these top 4 myth busters. Time now to roll up your sleeves and... Read more
Reader Question:
Code Lumbar and Sacral Spine Subluxation
Question: A patient presents with a subluxation of the lumbar and sacral spine with... Read more
Reader Question:
Know Who Can Request a Consultation Note
Question: A provider has documented a consultation note for a patient whom a nurse ... Read more
Reader Question:
Why Is G8730 the Most Sought After Pain Reporting Code?
Question: The provider sees a new patient. The provider does a pain assessment that... Read more
Reader Question:
Yes, a Participating Provider Can Bill the Patient for Non-Covered Services
Question: As a participating provider with Medicare, am I allowed to bill the patie... Read more
You Be the Coder:
CMT Codes Do Not Need Modifier 51
Question: A patient with a complaint of back pain presented to the doctor. After id... Read more
Reimbursement:
Make the Grade With ACA's New PQRS Reporting Recommendations
Secure your 2017 payments by apt reporting of two measures. Though the deletion of mea... Read more
Reimbursement:
Take a Giant Leap Forward in Payments with the New "X" Modifiers
Successfully implement the X {EPSU} Modifiers with this useful tip. Started working wi... Read more
ICD-10 Update:
Ward Off Your ICD-10 Fears With These Impeccable Documentation Tips
Plus: Take on a 20 minutes a day to master ICD-10 ready documentation. ICD-10 will req... Read more
Reader Question:
How to Report Additional Diagnoses in the CMS 1500 Form
Question: How do I report other diagnoses associated with the primary diagnosis of ... Read more
Reader Question:
Are Non-Par Providers Subject to Medicare Audits?
Question: Are non-par providers not subject to Medicare audits/ reviews? Texas Su... Read more
Reader Question:
Can Chiropractors Opt Out of Medicare?
Question: Can chiropractors opt out of Medicare? California Subscriber Answer:&... Read more
Reader Question:
Know Your Covered Chiropractic Services
Question: What are the covered chiropractic services under Medicare? Florida Subs... Read more
You Be the Coder:
Documenting a New Follow-Up Functional Outcome Assessment
Question: A patient completes a new Oswestry questionnaire. The doctor notes that t... Read more
Reimbursement:
Master the Four New Offshoots to Modifier -59 in 2015
Usher in greater accuracy with the new “X” modifiers. Watch out for the ne... Read more
Modifier -59 Defined
As per the CPT® Manual, “Distinct Procedural Service: Under certain circumstan... Read more
Compliance:
Brace Yourself for the Work Plan OIG Has Up Its Sleeve for Chiropractors
Safeguard your practice with these three strategic tips. The Office of Inspector Gener... Read more
PQRS 2015:
Don't Miss Your Most Important Change to PQRS 2015
Strike off measure 317 from your PQRS reporting list. CMS released new updates to the ... Read more
ICD-10 Update:
Coding for Whiplash? Delve Deeper Into the Long Descriptors
Tips on four most common neck pain diagnoses. Have you made your very own GEM list of ... Read more
Reader Question:
Reimbursement to a Non-Par Provider
Question: How does the reimbursement differ when a non-par provider of chiropractic... Read more
Reader Question:
Can a Chiropractic Bill for DME?
Question:The chiropractic decides that his patient requires a lumber belt for his condit... Read more
Reader Question:
Number of ABNs Needed for Regular Maintenance Therapy
Question: One of our patients requires services which will essentially come under t... Read more
You Be the Coder:
Will an X-Ray Older Than 12 Months Suffice for a Chronic Subluxation?
Question: There is a patient with an existing chronic subluxation with scoliosis fo... Read more