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Chiropractic office visit

Karen Posted Wed 10th of July, 2013 16:02:32 PM

How can I bill for a chiropractic office visit '99202' with manipulation. Our state medicare recently denied this for the reason: provider is not eligible to order the service billed?
Please advise.

SuperCoder Answered Thu 11th of July, 2013 01:18:38 AM

The chiropractic manipulative treatment codes include a pre-manipulation and postservice patient assessment. Additional Evaluation and Management services may be reported separately using the modifier-25, if and only if the patient’s condition requires a significant separately identifiable E/M service, and above and beyond the usual preservice and postservice work associated with the procedure.Here’s the interpretation: if you perform an extensive new patient exam and adjust the patient on the first visit, you could use 99202-25 or 99203-25 in addition to the CMT(chiropractic manipulative treatment) code. Likewise, if the patient experiences an exacerbation, a new injury or different symptoms, you could justify the E/M code along with the CMT code. Otherwise, the CMT code includes the pre- and post-adjustment exams such as palpation and leg checks that the doctor performs on an ongoing basis.

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