"Chiropractic" & "Topic Pages" Articles


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Müller Muscle Conjunctival Resection Versus External Levator Advancement

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Staging and Grading Periodontitis

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We now understand periodontitis may present itself as a manifestation of systemic diseases in fact; according to DeltaDental, research shows that more than 90 percent of all systemic diseases have oral manifestations, including swollen gums, mouth ulcers, dry mouth, and excessive gum problems. Some of these diseases include: Diabetes Leukemia Oral cancer Pancreatic cancer Heart ...

Summary of 2019 Changes to the ADA Dental Form

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In 2019 the ADA revised the ADA Dental claim form to incorporate editorial changes to further its consistency with the 837D. The previous update was in 2012, the changes in 2012 were made to incorporate the capability to report diagnoses codes.   Some of the important changes include Bx# 8 and 15, the description was updated ...

Dental-Provider Specialty Taxonomy Codes

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The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general ...

ICD-10-CM Cracks Down on the Use of "Unspecified" in the 2021 Official Guidelines

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We always knew there would come a day when payers would look down on an "unspecified" diagnosis code and possibly even deny it or delay payment until a review of the record could be performed. ICD-10-CM was adopted by the U.S. for data analytics, which cannot be accurate if unspecified codes are reported when the documentation verifies greater specificity. Join us for a look at the many guideline changes to ICD-10-CM, a review of the newest code changes and suggestions on documentation improvement to elevate coding protocols.

Watch out for New ICD-10-CM Codes

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New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.

​​Polysomnography Services Under OIG Scrutiny

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The OIG conducted a study dated June 2019 wherein they indicated that there were approximately $269 million in overpayments for polysomnography services for the period of 2014 through 2015. According to the OIG “These errors occurred because the CMS oversight of polysomnography services was insufficient to ensure that providers complied with Medicare requirements and to prevent payment of claims that didn’t meet those requirements.” So what are those requirements?

Billing Dental Implants under Medical Coverage

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Implants can be costly to the patient and the provider, and it is crucial to understand how to bill a patient’s medical insurance to ensure there is adequate coverage for the best treatment. Implants are commonly billed in a dental office under a patient’s medical benefits.    Implants could be considered ...

New Codes for COVID Booster Vaccine & Monoclonal Antibody Products

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New codes have been announced for the COVID-19 booster vaccine, Novavax vaccine, and monoclonal antibody treatment.

Understanding How Place of Service Codes Work

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The Place of service (POS) codes are used by CMS, Medicaid, and other private insurance to indicate where medically related items and services are sold or dispensed for a patient. POS codes are used for professional billing and are required to be reported on each claim submitted on a CMS-1500 ...

Compliance in the Dental Office or Small Practice

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If your practice does not already have a compliance program in place, you will want to get started after reading this article. We have uncovered some important findings with the Office of Inspector General (OIG) in dental practices you need to be aware of. A compliance program offers standard procedures to follow, ...

UCR Anesthesia Fee Calculations and Base Units - Now Available!

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As per customer request, Find-A-Code now offers UCR Anesthesia Fee Calculations along with CMS and ASA. The anesthesia fee calculations can be found under the Fees section of the code and under the Anesthesia Fee Information.   Time units are computed by dividing the reported anesthesia time by 15 minutes (17 minutes / 15 minutes = 1.13 units). NOTE: Always ...

Important Changes to Shared/Split Services

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Reporting of split (or shared) services has always been wrought with the potential for incorrect reporting when the fundamental principles of the service are not understood. A recent CMS publication about these services further complicates the matter.

PCS Coding for Ankle Fracture - Look Deeper Into the Codes!

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If you're looking for ankle fractures in ICD-10-PCS, you may need to look a little deeper. Let's take a look at coding an ankle fracture such as a trimalleolar fracture. PCS coding can be confusing as it is nothing like CPT coding; with CPT we can simply code an ankle ...

Intersegmental Traction — What’s Happening with Roller Tables?

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Intersegmental traction therapy via the use of roller tables has been used by doctors of chiropractic for many years. Recently, questions have arisen regarding the appropriate billing of roller tables. This is largely due to the statement published in the July 2020 CPT Assistant published by the American Medical Association (AMA). Which code should you really be using?

Comparison of Add-On Code Guidelines

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Add-on codes are codes that are not intended to be reported alone. They are reported with another primary procedure to identify that additional services have been provided in conjunction with that primary procedure. Generally, they include the words “List separately in addition to code.” Interestingly, there are some differences in the instructions/guidelines regarding the use of these codes in the CPT® codebook, the NCCI Policy Manual, and on the CMS website. This article outlines the differences between each of these.

Coding Lesions and Soft Tissue Excisions

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There are several considerations to be aware of before assigning a code for lesions and soft tissue excisions. The code selection will be determined upon the following: Check the pathology reports, if any, to confirm Morphology (whether the neoplasm is benign, in-situ, malignant, or uncertain) Technique Topography (anatomic location) The size Tissue Level Type of closure required Layers ...

58% of Improper Payments due to Medical Necessity for Ventilators

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Proper documentation not only protects the provider, the payer, and the patient, it protects the integrity of the entire healthcare system. When it comes to coverage and documentation for durable medical, the DMEPOS supplier and staff must be familiar with the National and Local Coverage Determinations (NCDs and LCDs) as these are ...

Properly Reporting Imaging Overreads (Including X-Rays)

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hile many provider groups offer some imaging services in their offices, others may rely on external imaging centers. When the provider reviews images performed by an external source (e.g., independent imaging center), that is typically referred to as an overread or a re-read. Properly reporting that work depends on a variety of factors as discussed in this article.

Understanding Skin Biopsy Codes

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A biopsy is a procedure to obtain only a portion of a lesion for a pathologic exam. According to the AMA, "The use of a biopsy procedure code (e.g., 11102, 11103) indicates that the procedure to obtain tissue for pathologic examination was performed independently, or was unrelated or distinct from other ...

ICD-10-CM 2021 Codes for your Specialty

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21. Factors influencing health status and contact with health services (Z00-Z99)    Code:            Description:Z03.821         Encounter for observation for suspected ingested foreign body ruled outZ03.822         Encounter for observation for suspected aspirated (inhaled) foreign body ruled outZ03.823         Encounter for ...

ICD-10-CM 2021 Codes for your Specialty

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4. Endocrine, nutritional and metabolic diseases (E00-E89) Code:            Description:E70.81          Aromatic L-amino acid decarboxylase deficiencyE70.89          Other disorders of aromatic amino-acid metabolismE74.810        Glucose transporter protein type 1 deficiencyE74.818        Other disorders of glucose transportE74.819    ...

ICD-10-CM 2021 Codes for your Specialty

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5. Mental, Behavioral and Neurodevelopmental disorders (F01-F99) Code:          Description:F10.130       Alcohol abuse with withdrawal, uncomplicatedF10.131       Alcohol abuse with withdrawal deliriumF10.132       Alcohol abuse with withdrawal with perceptual disturbanceF10.139       Alcohol abuse with withdrawal, unspecifiedF10.930       Alcohol use, unspecified with withdrawal, ...

ICD-10-CM 2021 Codes for your Specialty

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6. Diseases of the nervous system (G00-G99) Code:            Description: G11.10          Early-onset cerebellar ataxia, unspecifiedG11.11          Friedreich ataxiaG11.19          Other early-onset cerebellar ataxiaG40.42          Cyclin-Dependent Kinase-Like 5 Deficiency DisorderG40.833        Dravet syndrome, intractable, ...

ICD-10-CM 2021 Codes for your Specialty

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7. Diseases of the eye and adnexa (H00-H59) Code:            Description: H18.501        Unspecified hereditary corneal dystrophies, right eyeH18.502        Unspecified hereditary corneal dystrophies, left eyeH18.503        Unspecified hereditary corneal dystrophies, bilateralH18.509        Unspecified hereditary corneal dystrophies, unspecified eyeH18.511        Endothelial ...

ICD-10-CM 2021 Codes for your Specialty

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10. Diseases of the respiratory system (J00-J99) Code:            Description:J82.81           Chronic eosinophilic pneumoniaJ82.82           Acute eosinophilic pneumoniaJ82.83           Eosinophilic asthmaJ82.89           Other pulmonary eosinophilia, not elsewhere classifiedJ84.170         Interstitial lung disease with ...

ICD-10-CM 2021 Codes for your Specialty

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11. Diseases of the digestive system (K00-K95) Code:            Description:K20.80          Other esophagitis without bleedingK20.81          Other esophagitis with bleedingK20.90          Esophagitis, unspecified without bleedingK20.91          Esophagitis, unspecified with bleedingK21.00          Gastro-esophageal reflux disease with esophagitis, ...

ICD-10-CM 2021 Codes for your Specialty

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13. Diseases of the musculoskeletal system and connective tissue (M00-M99) Code:            Description:M05.7A          Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvementM05.8A          Other rheumatoid arthritis with rheumatoid factor of other specified siteM06.0A        ...

ICD-10-CM 2021 Codes for your Specialty

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14. Diseases of the genitourinary system (N00-N99) Code:            Description:N00.A            Acute nephritic syndrome with C3 glomerulonephritisN01.A            Rapidly progressive nephritic syndrome with C3 glomerulonephritisN02.A            Recurrent and persistent hematuria with C3 glomerulonephritisN03.A          ...

ICD-10-CM 2021 Codes for your Specialty

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16. Certain conditions originating in the perinatal period (P00-P96) Code:            Description:P91.821         Neonatal cerebral infarction, right side of brainP91.822         Neonatal cerebral infarction, left side of brainP91.823         Neonatal cerebral infarction, bilateralP91.829         Neonatal cerebral infarction, unspecified side ...

ICD-10-CM 2021 Codes for your Specialty

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18. Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) Code:            Description:R51.0            Headache with orthostatic component, not elsewhere classifiedR51.9            Headache, unspecifiedR74.01          Elevation of levels of liver transaminase levelsR74.02     ...

ICD-10-CM 2021 Codes for your Specialty

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19. Injury, poisoning and certain other consequences of external causes (S00-T88) Code:            Description:S20.213A      Contusion of bilateral front wall of thorax, initial encounterS20.213D      Contusion of bilateral front wall of thorax, subsequent encounterS20.213S      Contusion of bilateral front wall of thorax, sequelaS20.214A      Contusion of ...

ICD-10-CM 2021 Codes for your Specialty

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20. External causes of morbidity (V00-Y99) Code:            Description:V00.031A       Pedestrian on foot injured in collision with rider of standing electric scooter, initial encounterV00.031D       Pedestrian on foot injured in collision with rider of standing electric scooter, subsequent encounterV00.031S       Pedestrian on foot injured ...

Critical Evaluation and Management Changes Recently Announced by AMA

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On March 9, 2021, the American Medical Association (AMA) announced some pretty significant changes in relation to reporting Evaluation and Management (E/M) services, particularly for Office or Other Outpatient Services (99202-99215). The AMA Editorial Panel had previously met to discuss how to address concerns and made changes surrounding Office or Other Outpatient Services which are retroactive to January 1, 2021. Learn more about those changes in this article.

How To Properly Report Prolonged Services Using 99417 or G2212

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Prolonged Evaluation & Management codes underwent big changes in 2021, including the creation of a new prolonged code (99417), reportable only with codes 99205 or 99215. While Medicare has agreed to accept the AMA's CPT E/M coding changes, they have formulated an opinion contrary to how CPT calculates time specific ...

Good and Bad News Regarding the 2021 Medicare Physician Fee Schedule

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When the proposed Medicare Physician Fee Schedule came out last year, it really got everyone worried. In a time where we are all facing issues related to COVID, this seemed like a really big problem. Professional organizations lobbied and everyone tried to stop the proposed changes, and the 10.2% decrease didn’t happen, but other changes will still be taking place. So how bad is it really and how will it affect your organization?


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