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Chiropractic Coding & Compliance Alert

Reader Question:

Figure Out the Cause of Denials

Question: Our claims are getting rejected for incorrect diagnoses. What could be the probable reasons for this?

Texas Subscriber

Answer: First, check every single diagnosis used to ensure that your diagnosis codes are as per the ICD-10 guideline and coding instructions. Make sure that your software is not adding the diagnosis decimal point on the claim forms by default, as an unsolicited decimal point in a diagnosis code will result in rejection. What’s more, make sure that you use the seventh character well, when it comes to the injury based code. If this does not solve the problem, it is best to check with the payers.  

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