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98940 Denial

Annette Posted Tue 03rd of January, 2017 09:04:00 AM
I can't find my original question that I asked about a month ago. I wanted to know if an MD could bill Chiropractic spinal manipulations codes 98940. I thought I was told yes. We are getting rejections for the MD billing 98940 because of the specialty. Is there a modifier or something that I should be using?
SuperCoder Answered Wed 04th of January, 2017 05:50:38 AM

Hi, you may like to refer to the following link for some clarity on this. Please let us know if you have any further query. Thank you.

Annette Posted Wed 04th of January, 2017 09:05:38 AM
Can you give me an example of a regional disgnosis code and a regional specific diagnosis code? It says if you are manipulation 3 areas you need 6 diagnosis codes. Thanks!
SuperCoder Answered Thu 05th of January, 2017 00:54:29 AM

Please find the following link. The section under "Diagnoses Covered" gives good information of the type and number of diagnosis codes required to support chiropractic manipulative treatment CPT. Hope this helps. Thank you.

Annette Posted Fri 13th of January, 2017 12:54:13 PM
Hi, Can you give me an example ICD10 code of a secondary diagnosis code from Categories I, II or III? I can't find anything information on what that is. Thanks!
SuperCoder Answered Mon 16th of January, 2017 04:33:22 AM

The secondary diagnoses are the supporting codes which basically represent the cause of subluxation. There are few examples as follows: One of the most common Category I code is 723.1 Cervicalgia, the GEM being M54.2 Cervicalgia. An example of category II code is 847.0 Neck sprain, the GEMs being S13.4XXA Sprain of ligaments of the cervical spine, initial encounter and S13.8XXA Sprain of joints and ligaments of other parts of the neck, initial encounter. Category III code example, 722.4 Degeneration of a cervical intervertebral disc, with an equivalent GEM leading to M50.30 Other cervical disc degeneration, unspecified cervical region. Hope this helps. Thank you.

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