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"Chiropractic" Articles
Click on the title to see the article summary and a link to the full article.
January 11th, 2021
Good and Bad News Regarding the 2021 Medicare Physician Fee Schedule
By Wyn Staheli, Director of Research | Published January 11th, 2021
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?
December 31st, 2020
CMS Final Rule Changes E/M Reporting Guidelines
By Wyn Staheli, Director of Research | Published December 31st, 2020
Just when we thought we had figured out Evaluation and Management (E/M) reporting for 2021, CMS released their final rule and now we will need to make some adjustments. While CMS stated that they were adopting the AMA guidelines for E/M office or other outpatient services, they did make a few changes.
December 22nd, 2020
ICD-10-CM 2021 Codes for your Specialty
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 22nd, 2020
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 ...
October 7th, 2020
Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program
By Wyn Staheli, Director of Research | Published October 7th, 2020
To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.
September 29th, 2020
ICD-10-CM 2021 Coding Updates for Chiropractic
By Wyn Staheli, Director of Research | Published September 29th, 2020
October 1st is just around the corner and that means it’s time for updates to the ICD-10-CM code set. This year there are some interesting changes such as a new headache type, new codes related to TMJ, several new codes for reporting accidents involving micro-mobility devices (e.g., hoverboard), and some other changes.
June 3rd, 2020
Watch for Payer Telehealth Coverage Changes
By Wyn Staheli, Director of Research | Published June 3rd, 2020
As our country moves forward with a phased approach to reopening, be sure to pay close attention to individual payer policies regarding how long these changes will remain in effect. Keep in mind that private payer, federal programs (Medicare, Medicaid), and Medicare Advantage plans can all have different timelines as well as different coverage.
May 12th, 2020
Getting Your Practice Back on Track
By Wyn Staheli, Director of Research | Published May 12th, 2020
As we begin returning back to work, we will all face a new normal. The COVID-19 pandemic has changed the face of business. While it has certainly been a challenge to keep up with the ever-changing regulations (that’s likely to continue for a little longer), exciting new opportunities have also been created, such as the expansion of telemedicine. There’s also the maze of government funding that needs to be navigated and an increased awareness of OSHA standards to implement.
April 13th, 2020
COVID-19 Chiropractic Resources
By Wyn Staheli, Director of Research | Published April 13th, 2020
COVID-19 Chiropractic Resources contains current, updated information regarding COVID-19. Included are lists of webinars, articles, websites and links pertaining to the ongoing changes.
April 7th, 2020
More Telehealth Changes Announced by CMS Chiropractic Offices Should Know About
By Wyn Staheli, Director of Research | Published April 7th, 2020
On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). The announcement included far more information than is presented in this article which only summarizes the changes to telehealth. In fact, it does change a little of the information included in our March 31st webinar.
March 31st, 2020
CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published March 31st, 2020
Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly. Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...
March 25th, 2020
COVID-19: Cybercrime, Telehealth, and Coding
By Wyn Staheli, Director of Research | Published March 25th, 2020
Your inbox is probably like mine with all sorts of announcements about COVID-19. Here are just a few reminders of things we felt should be passed along.
We have heard of several cases of cybercrime related to this outbreak. For example, there was a coronavirus map which loads malware onto your ...
February 20th, 2020
Acupuncture Clarification
By Wyn Staheli, Director of Research | Published February 20th, 2020
In the ChiroCode Newsletter released yesterday regarding Medicare coverage of acupuncture, one sentence in particular has let to some confusion. Read more about it here.
February 19th, 2020
Medicare Begins Covering Acupuncture Services
By Wyn Staheli, Director of Research | Published February 19th, 2020
Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.
February 19th, 2020
Q/A: Did Noridian Stop Covering the M99.0- Codes?
By Wyn Staheli, Director of Research | Published February 19th, 2020
Question: I heard that Medicare Noridian Jurisdiction F (Alaska) has been denying claims with M99.00, M99.01, M99.02, M99.03 etc codes when billed with the CMT CPT codes. Did Medicare change their policy?
January 21st, 2020
Inadequate Exclusion Screenings Could Put Your Practice at Risk
By Wyn Staheli, Director of Research | Published January 21st, 2020
Exclusion screenings require far more than just checking a name on a federal database at the time you are hiring someone. Far too many providers don’t realize that in order to meet compliance requirements, there is MUCH more involved. There are actually over 40 exclusion screening databases/lists that need to be checked.
January 14th, 2020
Billing for Telemedicine in Chiropractic
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published January 14th, 2020
Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.
January 14th, 2020
Q/A: Can Chiropractors Bill 99211?
By Wyn Staheli, Director of Research | Published January 14th, 2020
Can chiropractic offices bill code 99211? Technically it can be used by chiropractors, but in most instances, it is discouraged. Considering that 99211 is a low complexity examination for an established patient, this code is not really made for the physician to use. In fact, in 2021, changes are coming for this code...
December 3rd, 2019
Q/A: Can I Order a TENS unit for a Medicare Patient?
By Wyn Staheli, Director of Research | Published December 3rd, 2019 - Last Review/Update December 4th, 2019
Question
Can a chiropractor order a TENS unit for a Medicare patient? We cannot order X-rays for a Medicare patient so I assume we cannot order a TENS unit either.
Answer
It’s not that you can’t order the TENS unit, it’s just that when it comes to doctors of chiropractic, Medicare only covers ...
December 3rd, 2019
Answering the Question: Does my Insurance Cover Chiropractic Care?
By Wyn Staheli, Director of Research | Published December 3rd, 2019 - Last Review/Update December 4th, 2019
The question "Does my insurance cover chiropractic care" is the ongoing question chiropractic offices have struggled with for years. Unfortunately, when it comes to insurance, coverage often varies between payers — even varying between plans for a single payer so there isn't one easy answer.
November 19th, 2019
Q/A: How do I Code a Procedure for the Primary Insurance so the Secondary Can Get Billed?
By Wyn Staheli, Director of Research | Published November 19th, 2019
Question: How do you modify a code submitted to the primary insurance company to let them know it is not covered by them so you can bill to a secondary?
November 19th, 2019
Changes to Portable X-Ray Requirements
By Wyn Staheli, Director of Research | Published November 19th, 2019
On September 30, 2019, CMS published a final rule which made changes to portable x-ray services requirements as found in the law.
October 1st, 2019
Federal Workers Compensation Information
By Wyn Staheli, Director of Research | Published October 1st, 2019
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program.
Division of Federal Employees' Compensation (DFEC) website
Division of Federal Employees' Compensation (DFEC) provider ...
September 30th, 2019
New Codes for Dry Needling
By Wyn Staheli, Director of Research | Published September 30th, 2019
Find out what you need to know about the new codes for dry needling, also known as trigger point acupuncture.
September 30th, 2019
CMS and HHS Tighten Enrollment Rules and Increase Penalties
By Wyn Staheli, Director of Research | Published September 30th, 2019
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019.
There have been known problems ...
September 9th, 2019
Q/A: Is the Functional Rating Index by Evidence-Based Chiropractic Valid?
By Wyn Staheli, Director of Research | Published September 9th, 2019
Question
Is the Functional Rating Index, from the Institute of Evidence-Based Chiropractic, valid and acceptable? Or do we have to use Oswestry and NDI?
Answer
You can use any outcome assessment questionnaire that has been normalized and vetted for the target population and can be scored so you can compare the results from ...
August 20th, 2019
Attention Chiropractors!
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 20th, 2019
Find-A-Code has created a TOPIC page specifically for Chiropractors. Check it out! We have simplified your search with Articles, Tips, Webinars, and Tools all in one place for your convenience.
Be sure to visit us today. Simply go to Findacode.com then hover over TOPICS at the top of the page, then select Chiropractic.
...
August 16th, 2019
Medical ID Theft
By Namas | Published August 16th, 2019 - Last Review/Update August 20th, 2019
Medical ID Theft
"So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...
August 13th, 2019
Will Medicare Change Their Rules Regarding Coverage of Services Provided by a Chiropractor?
By Wyn Staheli, Director of Research | Published August 13th, 2019
Two separate pieces of legislation introduced in the House of Representatives (H.R. 2883 and H.R. 3654) have the potential to change some of Medicare’s policies regarding doctors of chiropractic. Find out what these two bills are all about and how they could affect Medicare policies.
August 9th, 2019
The OIG Work Plan: What Is It and Why Should I Care?
By Namas | Published August 9th, 2019 - Last Review/Update August 14th, 2019
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
July 29th, 2019
The Role of Chiropractic in Value Based Payment Systems
By Wyn Staheli, Director of Research | Published July 29th, 2019
Chiropractic care can play a valuable role in overall patient health. It is important to realize that chiropractors can effectively participate in Medicare's new value based payment systems. Read about one organization who has made this transition.
July 29th, 2019
Q/A: How do I Bill Mobile Clinic Services?
By Evan Gwilliam DC, MBA, BS, CPC, CCPC, CPC-I, QCC, MCS-P, CPMA, CMHP, AAPC Fellow | Published July 29th, 2019
Question: I have a part time mobile clinic. I travel to treat patients at their homes. Are there special considerations when billing for these encounters?
July 22nd, 2019
Q/A: What do I Need to Document for Periodic Adjustments on a Medicare Patient?
By Evan Gwilliam DC MBA BS CPC NCICS CCPC CCCPC CPC-I MCS-P CPMA | Published July 22nd, 2019
Question:
What type of documentation is required for a Medicare patient with degenerative joint disease who get adjusted once or twice a month for occasional flare-ups of the D. J. D. region? The noted adjustments give good relief of the patient's symptoms.
Answer:
There is no question that these adjustments would be considered ...
July 17th, 2019
Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain
By Wyn Staheli, Director of Research | Published July 17th, 2019
Now is the time to comment on a proposal to cover acupuncture for chronic low back pain. This comment period is the part of the HHS response to the opioid crisis. You only have until August 14th to officially comment.
July 15th, 2019
Q/A: Do I Use 7th Character A for all Sprain/Strain Care Until MMI?
By Wyn Staheli, Director of Research | Published July 15th, 2019
Question:
It is in regards to the Initial and Subsequent 7th digit (A and D) for sprains and strains. Recently, I have been told that I should continue with the A digit until the patient has reached Maximum Medical Improvement (MMI) and then switch over to the D place holder. Is ...
July 12th, 2019
5 Ways to Minimize HIPAA Liabilities
By BC Advantage | Published July 12th, 2019 - Last Review/Update July 30th, 2019
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability.
Take ...
July 8th, 2019
Q/A: Can I Put the DC’s NPI in Item Number 24J for Massage Services?
By Wyn Staheli, Director of Research | Published July 8th, 2019
Question:
Are there scenarios in which it is acceptable to put the DC's NPI in box 24j for massage services?
Answer:
While the answer to this is yes, it is essential to understand that there are very limited scenarios. In most cases, Item Number 24J is only for the NPI of the individual ...
July 8th, 2019
Will the New Low Level Laser Therapy Code Solve Your Billing Issues?
By Wyn Staheli, Director of Research | Published July 8th, 2019
Low level laser therapy (LLLT), also known as cold laser therapy, is a form of phototherapy which uses a device that produces laser beam wavelengths, typically between 600 and 1000 nm and watts from 5–500 milliwatts (mW). It is often used to treat the following:
Inflammatory conditions (e.g., Rheumatoid Arthritis, Carpal ...
July 1st, 2019
Rules for Rendering Unproven, Investigational or Experimental Procedures
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published July 1st, 2019
If you haven’t reviewed your state guidelines or taken a recent look at third-party payer policies on unproven, investigational or experimental procedures, now is the perfect time to make sure you’re up to speed with this important information. Most providers are surprised to see commonly used devices or techniques listed ...
July 1st, 2019
Q/A: Do I Really Need to Have an Interpreter?
By Wyn Staheli, Director of Research | Published July 1st, 2019
Question:
I heard that I need to have an interpreter if someone who only speaks Spanish comes into my office. Is this really true?
Answer:
Yes! There are both state and federal laws that need to be considered. The applicable federal laws are:
Title VI of the Civil Rights Act of 1964,
Americans with Disabilities ...
June 25th, 2019
Q/A: Can I Refuse to File a Patient's Medical Insurance for an Auto Accident?
By Wyn Staheli, Director of Research | Published June 25th, 2019
Question:
Can a Chiropractor refuse to file a patients Medical Insurance for an Auto Accident?
Answer:
There isn't a simple answer to this question. It depends on who is responsible and state laws. Who is responsible (the auto insurance or the medical insurance) can depend on state requirements as well as who is ...
May 29th, 2019
Noting "Noncontributory" for Past Medical, Family, Social History - Is It Acceptable?
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published May 29th, 2019 - Last Review/Update June 4th, 2019
Is "noncontributory" really an unacceptable word to describe a patient whose family history doesn't have any bearing on the condition being evaluated and treated today?
May 27th, 2019
Q/A: For Physical Therapy Claims, What is the Correct Modifier Order?
By Wyn Staheli, Director of Research | Published May 27th, 2019 - Last Review/Update June 6th, 2019
Question
Page 116 of the 2019 ChiroCode Deskbook shows examples for Medicare modifiers. Is this the specific order for the modifiers to be entered? Our practice management software system is advising the GP or GY should be used as Modifier 1 and not as Mod 2 or Mod 3.
Also, it shows the ...
May 27th, 2019
Your New Patient Exam Code Could Determine How Many Visits You Get
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published May 27th, 2019 - Last Review/Update June 6th, 2019
The initial exam is where the provider gathers the information to determine the need for all the care that follows. It is billed most often as an office or outpatient evaluation and management (E/M) code from the 4th edition of the AMA’s Current Procedural Terminology book. There are actually five ...
May 13th, 2019
Electrical Stimulation and Electromagnetic Therapy Devices
By Raquel Shumway | Published May 13th, 2019 - Last Review/Update May 20th, 2019
Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint.
April 29th, 2019
Q/A: I’m Being Audited? Is There a Documentation Template I can use?
By Wyn Staheli, Director of Research | Published April 29th, 2019
Question: Our Medicare contractor is auditing claims with 98942. Do you have any suggestions for a template for documentation to warrant the use of 98942?
Answer: When you submit a claim with code 98942 you are stating that you have determined that it was medically necessary to adjust all 5 of ...
April 22nd, 2019
Auditing Chiropractic Services
By By Evan M. Gwilliam, DC MBA BS CPC CCPC CPC-I QCC MCS-P CPMA CMHP AAPC Fellow Clinical Director, PayDC Chiropractic EHR Software President, Gwilliam Consulting LLC drgwil@gmail.com | Published April 22nd, 2019
Chiropractic is unique from other types of health care and auditors need to be aware of the nuances of this field. Chiropractic has become the focus of more and more audits as doctors seem to struggle to create records that properly support the care provided to the patient throughout the entire episode.
April 22nd, 2019
Q/A: What’s Wrong with the Diagnoses on my Claim?
By Wyn Staheli, Director of Content | Published April 22nd, 2019
Question: I got a denial on my claim and it said the problem was with the diagnoses codes that I used. I used M54.15 and M79.2. I don’t understand why this is a problem.
April 1st, 2019
Q/A: I Submitted a Claim to the VA and it’s Being Denied. Why?
By Wyn Staheli, Director of Research | Published April 1st, 2019
I submitted a claim to the VA and it’s being denied. Why?
There are several reasons why your claim might be denied by the Veterans Administration (VA). However, without more information about the claim itself (e.g., services billed), we can only provide the following general information about the VA and chiropractic ...
April 1st, 2019
Corrections and Updates
By Wyn Staheli, Director of Research | Published April 1st, 2019 - Last Review/Update April 2nd, 2019
One constant in our industry is change. Policies change, contracts change, and there are updates. Also, people aren’t perfect and mistakes can be made. So this article will cover a variety of topics.
Published Articles
We appreciate feedback from our valued customers. We have received feedback regarding two of our articles which ...
February 25th, 2019
Medicare Supplemental Policies (MediGap) and Extremity Adjustments
By Wyn Staheli, Director of Research | Published February 25th, 2019
The nice thing about MediGap policies is that they pay for some of the healthcare costs that an original Medicare plan (Part B) does not cover. So when a patient has Medicare and a Medicare supplement (MediGap) and their condition is related to an extremity (a noncovered service), Medicare must ...
February 22nd, 2019
Q/A: What's the Difference Between Q5 and Q6 for a Substitute Provider?
By Wyn Staheli, Director of Research | Published February 22nd, 2019 - Last Review/Update March 5th, 2019
It is important to understand that modifiers Q5 and Q6 are not interchangeable. So when do you use each of them?
February 7th, 2019
Q/A: Do Digital X-rays Have Their Own Codes?
By Wyn Staheli, Director of Research | Published February 7th, 2019 - Last Review/Update February 8th, 2019
Question
Are you aware if digital x-ray of the spine requires a different code than plain x-ray? If so, where can I find the information specific to digital x-ray codes?
Answer
There are no separate codes for digital x-rays. However, there may be modifiers that are required to be submitted with the usual ...
February 1st, 2019
Physical Therapy Caps Q/A
By Wyn Staheli, Director of Research | Published February 1st, 2019 - Last Review/Update February 4th, 2019
Question: How do I code it so that PT services in a chiropractic office don’t count against their PT visit max? Is there a way to code claims so that they are considered chiropractic only? But still get compensated enough? We have been running into some issues as of late ...
January 14th, 2019
AMA Issues new CMT Information
By Wyn Staheli, Director of Research | Published January 14th, 2019
As many of you may already be keenly aware, there have been ongoing problems with many payers (e.g., BCBS of Ohio) regarding the appropriateness of reporting an E/M visit on the same day as CMT (CLICK HERE to read article). The AMA recently released an FAQ which renders their opinion ...
January 3rd, 2019
Dry Needling
By Wyn Staheli, Director of Research | Published January 3rd, 2019
The correct coding of dry needling, also known as trigger point needling, has been a subject of confusion for quite some time. The American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA) have been working together for several years to obtain appropriate codes to describe this service. In ...
January 3rd, 2019
2019 Coding Changes for Chiropractic
By Wyn Staheli, Director of Research | Published January 3rd, 2019
The new year is upon us and so it’s time to double check and make sure we are ready. Those with Premium Membership can use the ChiroCode Online Library and search all the official code sets: ICD-10-CM, CPT, and HCPCS. It also includes the updated NCCI edits and RVUs for ...
December 20th, 2018
Flexion-Distraction Billing Clarification
By Wyn Staheli, Director of Research | Published December 20th, 2018
Recently we posted a Q/A with stated that Cox-flexion distraction was not billable with code 97012. We received a comment from a customer stating that was not entirely correct because there is an add-on to the standard Cox table which satisfied the mechanical requirements to use code 97012. This article ...
November 29th, 2018
Billing Exercise Equipment
By Wyn Staheli, Director of Research | Published November 29th, 2018
While equipment for home strengthening is arguably good for the patient and the prognosis of their condition(s), payers have very strict guidelines as to what is considered medically necessary when it comes to Durable Medical Equipment (DME). While I have seen some workers compensation policies which do pay for DME ...
November 28th, 2018
No Good Deed Goes Unpunished
By Dr. Ray Foxworth, MCS-P, President of ChiroHealthUSA | Published November 28th, 2018 - Last Review/Update January 21st, 2019
You simply need to read the headlines, posts, and tweets, about providers across the healthcare profession being audited, fined, and some even convicted, to see that the costs of non-compliance are real. We tell ourselves, “It won’t happen to me.” The reality is that it easily could. Your license is your livelihood.
November 26th, 2018
CMT Fees in 2019
By Wyn Staheli, Director of Research | Published November 26th, 2018 - Last Review/Update January 30th, 2019
Now is the time to prepare. There were some minor reductions to the RVUs for CMT codes 90840-90843. Check here to see what those changes are.
November 8th, 2018
Muscle Testing and Range of Motion Information
By Wyn Staheli, Director of Research | Published November 8th, 2018
Be sure to understand the unique code requirements for Muscle and Range of Motion Testing.
October 22nd, 2018
Q/A: Does My LMT need an NPI? How do I Bill Her Services?
By Wyn Staheli, Director of Research | Published October 22nd, 2018 - Last Review/Update December 19th, 2018
Question:
I am setting up an LMT to work as employee under Dr. Clifton, DC. i need to know several things - hoping they are related and can be grouped into this one question.... does she need her own NPI? where does that NPI # go? what box #? if not, ...
October 19th, 2018
Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder
By Wyn Staheli, Director of Research | Published October 19th, 2018 - Last Review/Update December 19th, 2018
The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association's Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers for Medicare and ...
October 17th, 2018
Wolters Kluwer Drug Pricing
By Find-A-Code | Published October 17th, 2018
Wolters Kluwer provides unit and package pricing for multiple drug price types: Average Wholesale Price (AWP), Wholesale Acquisition Cost (WAC), Direct Price (DP), Manufacturer's Suggested Wholesale Price (SWP), Centers for Medicare & Medicaid Services, Federal Upper Limit (CMS FUL), Average Average Wholesale Price (AAWP), Generic Equivalent Average Price (GEAP). Average...
October 16th, 2018
Q/A: What Diagnosis Codes Should I Use for TMJ Headache Massage for Coverage?
By Wyn Staheli, Director of Research | Published October 16th, 2018
Question:
We have been receiving several DDS referrals to our massage therapists who do intra-oral work. The only problem is that the referral from the DDS lists code R51 for headaches as the only DX code. Since most plans don't cover massage therapy for headaches alone, are there any codes that can distinguish the headaches as ...
October 16th, 2018
Q/A: What Codes do I use for CLIA-Waived Tests?
By Wyn Staheli, Director of Research | Published October 16th, 2018
Question:
I am a certified DOT medical examiner and have applied to get my CLIA lab (waiver) for urinalysis, finger prick blood tests for A1c, cholesterol and glucose. I realize I cannot diagnose patients with these tests, but I am using them to make decisions in the DOT process and with ...
September 24th, 2018
2019 Code Changes are Just Around the Corner - Are You Ready?
By Wyn Staheli, Director of Research | Published September 24th, 2018 - Last Review/Update January 28th, 2019
The leaves are beginning to change and it’s time once again for the annual code changes for 2019. ICD-10-CM codes are out and will be effective October 1, 2018. CPT code changes also just came out and will be effective January 1, 2019. The ChiroCode DeskBook and ICD-10-CM Coding for Chiropractic books have been ...
August 16th, 2018
Importance of Depression Screenings
By Wyn Staheli, Director of Research | Published August 16th, 2018
Why would a chiropractor be concerned about depression screenings when you aren’t trained to be a mental health provider? The answer lies in patient outcomes. Many quality care organizations recommend depression screenings for patients with a chronic condition. According to The National Institute of Mental Health, “People with other chronic ...
August 16th, 2018
Q/A: Can I Bill Mechanical Massage?
By Wyn Staheli, Director of Research | Published August 16th, 2018 - Last Review/Update January 30th, 2019
Are there any alternative procedure codes for billing mechanical massage (e.g., muscle master vibromassage, genie rub, etc)? I know that 'by the book' mechanical devices are not covered under 97124, but wondered if you have suggested a go-around code.
August 10th, 2018
Q/A: How Do I Release a Patient from PI When They Still Have Problems?
By Wyn Staheli, Director of Research | Published August 10th, 2018 - Last Review/Update January 28th, 2019
Once a PI patient is released with symptoms, or without symptoms, and a prognosis of likely exacerbations with a future medical estimation of $1500 over then next 2 years, how am I supposed to release them from care when they still have ongoing needs?
We have discussed this with several different experts. The consensus is....
July 25th, 2018
Q/A: Can I Bill Spinal Decompression Table to Insurance?
By Wyn Staheli, Director of Research | Published July 25th, 2018 - Last Review/Update January 28th, 2019
Are visits when a Chiropractor just uses a spinal decompression table billable to insurance? If so, what code is recommended?
July 12th, 2018
Q/A: Can You Swap Out 97140 with 97530?
By Wyn Staheli, Director of Research | Published July 12th, 2018 - Last Review/Update January 28th, 2019
Codes 97140 and 97530 are not interchangeable. See why.
June 20th, 2018
Q/A: Should I Bill Massage as 97124 or 97140?
By ChiroCode | Published June 20th, 2018 - Last Review/Update January 30th, 2019
Question
The code, 97124, Is specifically for massage but I have read that Insurance will more likely pay for 97140. Could we bill for whichever one pays? I believe that we have to indicate which area is used for CMT and which area for massage. Is it enough to document that ...
June 18th, 2018
Q/A: Can a PT Assistant Perform Physical Therapy Modalities?
By Wyn Staheli, Director of Research | Published June 18th, 2018 - Last Review/Update January 30th, 2019
Whether or not a physical therapy assistant (PTA) may perform physical therapy modalities depends on two factors: state law and payer policies. Read here for more.
May 1st, 2018
CEU’s Now Available
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published May 1st, 2018
CEU’s are now available for the following Webinars:
Practice Risk Areas, Presented by Brandy Brimhall (1 CEU)
Secrets of Chiropractic Documentation, Presented by Compliant Coding Systems. (4 CEU’s)
CEUs are available in the following states:
Alaska
Connecticut
District of Columbia
Idaho
Indiana
Iowa
Kansas
Maine
Maryland
Massachusetts
Minnesota
Montana
Nebraska
Nevada
New Jersey
North Carolina
North Dakota
Ohio
Oregon
Rhode Island
South Carolina
South Dakota
Tennessee
Utah
Washington
Vermont
Virginia
Wyoming
Puerto Rico
Nova Scotia
NOTE: "Additional states may be ...
April 30th, 2018
Q/A: Should I be Using Modifier 96 on PT Claims?
By Wyn Staheli, Director of Research | Published April 30th, 2018 - Last Review/Update January 30th, 2019
As chiropractors we feel the new modifier 97 is more appropriate than 96 for our PT codes such as stim and traction. Yet Carefirst is asking for 96 only. Should we use this code on all the PT codes and for all the other insurance companies?
April 12th, 2018
Billing Nutrition Counseling in a Chiropractic Setting
By Wyn Staheli, Director of Research | Published April 12th, 2018
Billing nutrition counseling services may not be as straight-forward as you might think. Some providers mistakenly choose Medical Nutrition Therapy (MNT) codes (97802-97804, G0270, G0271) because it states nutrition therapy in the title. However, according to CPT guidelines, when MNT assessment and/or intervention is performed by a physician or qualified healthcare professional ...
March 13th, 2018
When is 97112 Neuromuscular Re-education Billable?
By Dr. Evan Gwilliam, VP for PayDC | Published March 13th, 2018 - Last Review/Update January 31st, 2019
Q: I just received a note from an attorney regarding a patient who was rear ended about 40 mph and ended up with neuropathy in her upper and lower extremities. We treated her for about 3 months after previous care failed to give much relief. I used flexion distraction and deep muscle stimulation to break up adhesions from the injury and used the 97112 code of neuromuscular re-education. The insurance company said that code was not warranted for her spinal sprain diagnosis and denied all of the services. Do you know how I could justify it? It greatly improved her condition with each visit and the patient said we provided the greatest relief she received.
February 26th, 2018
OIG Issues Renewed Focus on Chiropractic Services
By Wyn Staheli, Director of Research | Published February 26th, 2018
The OIG recently released a "Portfolio" regarding chiropractic service which stated (emphasis added):
This portfolio presents an overview of program vulnerabilities identified in prior Office of Inspector General (OIG) audits, evaluations, investigations, and legal actions related to chiropractic services in the Medicare program. It consolidates the findings and issues identified in ...
February 1st, 2018
Strapping and Kinesio Taping Coding Differences
By Wyn Staheli, Director of Research | Published February 1st, 2018
There are differences between the purposes of strapping and taping and using the correct codes depends on the application - literally.
Strapping: This application is for the purpose of immobilizing an area. It is clinically indicated for the treatment of fractures, dislocations, sprains/strains, tendonitis, post-op reconstruction, contractures, or other deformities involving soft tissue.
Coding: ...
February 1st, 2018
Traumatic Subluxation Coding Controversy
By Wyn Staheli, Director of Research | Published February 1st, 2018
There has been some controversy over the use of the ICD-10-CM subluxation codes commonly referred to as traumatic (S13.1-, S23.1-, and S33.1-). Are they appropriate for chiropractors to use? The answer to that question is complicated. The problem basically lies in the lack of official guidance and differing opinions on ...
January 31st, 2018
Q/A: Can I Perform 2 Untimed Codes at the Same Time?
By Wyn Staheli, Director of Research | Published January 31st, 2018 - Last Review/Update February 4th, 2019
Question: Can two untimed codes be performed at the same time? For instance can I perform lumbar traction (97012) at the same time as e-stim (97014)?
January 16th, 2018
Patient Relationship Codes
By Wyn Staheli, Director of Research | Published January 16th, 2018
Section 1848(r)(4) of MACRA requires that claims submitted for items and services furnished by a physician or applicable practitioner on or after January 1, 2018, include codes for the following:
care episode groups
patient condition groups
patient relationship categories
Previously, CMS decided to use procedure code modifiers to report patient relationship codes on Medicare ...
January 15th, 2018
Medicare Requiring Specific Modifiers on Therapy Services
By Wyn Staheli, Director of Research | Published January 15th, 2018
Medicare's MLN Matters Number: MM10176 was recently revised to identify services subject to their therapy cap. The revision became effective on January 1, 2018 and some providers have begun to receive claim rejections because they are not using the appropriate modifier. The article states the following:
Services furnished under the Outpatient ...
January 15th, 2018
Billing with a GP Modifier
By Wyn Staheli, Director of Research | Published January 15th, 2018 - Last Review/Update January 30th, 2019
Q: When patients have a true Medicare secondary insurance we've always billed other Medicare non-covered codes such as G0283 for electric stimulation with modifier GY because we are aware Medicare will not pay for that service but the secondary insurance does. We just were notified by our MAC that GY is not a valid modifier and I have to enter a GP or other therapy modifier. What is the new proper modifier to enter?
January 9th, 2018
Should ROM Testing be Reported with Evaluation and Management Services?
By Aimee Wilcox, CPMA, CCS-P, CST, MA, MT, Director of Content | Published January 9th, 2018
Reporting the performance of range of motion testing (95851-95852) at the same encounter of an Evaluation and Management (EM) service, produces an NCCI edit resulting in payment for the EM service and denial of the ROM testing. Read the article to learn what other codes ROM testing is considered incidental to.
December 12th, 2017
Documenting the Location and Correct Coding
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published December 12th, 2017
The exact level of the subluxation must be specified in the documentation to substantiate payment of a claim.
You may document the exact bones such as C3, C3 or the area if it implies only certain bones such as the Occipito-atlantal - Occiput, and C1 (Atlas).
C1 is the first vertebra known as the atlas. The axis-form is ...
November 6th, 2017
New Payment Rulings Could Affect You
By Wyn Staheli, Director of Research | Published November 6th, 2017
Fall has always been the season for CMS fee changes and on November 2, 2017, CMS announced the finalization of four rules which directly impact the following payment systems:
Physician Fee Schedule Final Policy, Payment, and Quality Provisions for CY 2018
Hospital OPPS and ASC Payment System and Quality Reporting Programs Changes ...
October 31st, 2017
Correct Coding for Group Therapy
By David Klein CPC, CPMA, CHC | Published October 31st, 2017 - Last Review/Update February 5th, 2019
Recent events regarding delegation of services to ancillary personnel have given rise to concerns regarding the delivery of outpatient physical medicine by Chiropractors, specifically regarding the appropriate use of one-on-one codes as opposed to group therapy code CPT 97150 - Therapeutic procedure(s), group (2 or more individuals). This advisory provides guidance on how to properly use one-on-one and group therapy codes, both independently and together.
October 23rd, 2017
Summary of OIG Reports for Chiropractic
By | Published October 23rd, 2017
The Office of the Inspector General was created to protect the integrity of the U.S. Department of Health and Human Services. They investigate fraud, waste, and abuse in HHS programs and make recommendations to various enforcement agencies. Every few years they investigate chiropractic services. Here is a summary of the reports the ...
October 20th, 2017
What is the Best Code to use for PNF Stretching of the Hamstrings and Glutes?
By Brandy Brimhall, CPC CPCO CMCO CPMA QCC | Published October 20th, 2017 - Last Review/Update February 8th, 2019
What is the best code to use for PNF stretching of the hamstrings and gluts? The doctor is currently using 97112.
October 20th, 2017
A P.A.R.T. Template
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published October 20th, 2017 - Last Review/Update February 5th, 2019
Here at ChiroCode we are often asked for examples of perfect forms to use in the office. As such we have developed some.
October 13th, 2017
Can Chiropractors Opt-out of Medicare?
By Brandy Brimhall, CPC CPCO CMCO CPMA QCC | Published October 13th, 2017 - Last Review/Update February 5th, 2019
Chiropractors cannot opt-opt of Medicare. Does that only refer to chiropractors that see Medicare patients? Do all Florida chiropractors have to complete Medicare enrollment/credentialing? Bottom line- do ALL chiropractors, no matter where or who, have to complete Medicare enrollment since they cannot Opt-out?
October 5th, 2017
Q/A: Do we Need to Charge for Non-covered Services Performed Under a Maintenance Visit if we Use the S8990 Code When Billing Medicare?
By Brandy Brimhall, CPC CPCO CMCO CPMA QCC | Published October 5th, 2017 - Last Review/Update February 5th, 2019
Do we need to charge for non-covered services performed under a maintenance visit if we use the S8990 code when billing Medicare?
October 5th, 2017
Brace Yourself for New ICD-10 and CPT Codes for 2018!
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published October 5th, 2017 - Last Review/Update February 5th, 2019
What is new for Chiropractors for 2018? See for yourself the new ICD-10 and CPT Codes.
September 30th, 2017
Annual Wellness Visit & Health Risk Assessment
By Find-A-Code | Published September 30th, 2017 - Last Review/Update October 1st, 2017
Coding tips regarding Annual Wellness Visit and Health Risk Assessments
September 29th, 2017
Stark Law for Healthcare Providers
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published September 29th, 2017
Be aware of physician self-referral laws and how they affect your practice.
September 25th, 2017
Last Chance to Start Reporting MIPS
By ChiroCode | Published September 25th, 2017 - Last Review/Update February 5th, 2019
MIPS is a program that allows Medicare to collect data from providers about high quality low cost care that uses technology effectively. There are four categories and providers need to learn about the available measures so that they can pick the ones that make them look the best.
September 1st, 2017
Medicare Improper Payment Report for Chiropractic (2016)
By Wyn Staheli, Director of Research | Published September 1st, 2017 - Last Review/Update October 16th, 2017
The Medicare Improper Payment Report for 2016 has been released by the OIG. Please note that the improper payment rate does not measure fraud. Rather, it estimates the payments that did not meet Medicare coverage, coding, and billing rules. The estimated Medicare FFS payment accuracy rate (claims paid correctly) from ...
September 1st, 2017
Quick Tip from ChiroCode -- Documentation
By ChiroCode | Published September 1st, 2017 - Last Review/Update January 31st, 2019
Documentation Solutions, a quick tip video by Dr Gwilliam.
August 24th, 2017
Can They Deny Electrical Stimulation by Saying There is no Evidence that it Works?
By Dr Ronald J. Farabaugh | Published August 24th, 2017 - Last Review/Update February 5th, 2019
Topic: Electrical Stimulation (EMS)
Question: An orthopedic surgeon/IME recommended a denial for all electrical stimulation
(EMS) by stating that "according ODG electrical stimulation is experimental therefore not
medically necessary or eligible for reimbursement." Is that true?
August 17th, 2017
Quick Tip from the HelpDesk -- Code 97140
By ChiroCode | Published August 17th, 2017 - Last Review/Update January 31st, 2019
Watch this short video, "Secrets of 97140 Manual Therapy," to learn all that you need to know about the proper support for 97140.
ChiroCode_DeskBook_Tips_97140 from Innoventrum on Vimeo.
...
August 16th, 2017
Chiropractic's Unique Role in the Opioid Epidemic
By Dr. Ray Foxworth, Certified Medical Compliance Specialist, President of ChiroHealthUSA, Chiropractor | Published August 16th, 2017 - Last Review/Update February 5th, 2019
While scanning my news feed this morning, a few alarming words caught my eye: "Opioids could kill nearly as many Americans in a decade as HIV/AIDS has killed since the epidemic began in the early 1980s." Across America, people are talking about chiropractic as a safer alternative to opioid medication for pain relief, and yet, I don't think the magnitude of this opportunity has been realized by most doctors of chiropractic in this country.
August 8th, 2017
Delegation to Staff is not Allowed. Can I Bill for Group Exercises if I Supervise?
By Brandy Brimhall, CPC CPCO CMCO CPMA QCC | Published August 8th, 2017 - Last Review/Update February 5th, 2019
My state does not allow me to delegate the supervision of therapeutic exercises (97110). I am the licensed chiropractor. If I provide the constant attendance myself, can I do it for a group of patients? If so, how do I document and bill for this?
August 1st, 2017
HIPAA Training Requirements
By Wyn Staheli | Published August 1st, 2017 - Last Review/Update August 2nd, 2017
HIPAA Training must be an ongoing effort in every healthcare organization.
June 15th, 2017
Negotiating Free Rent – For Medical Professional Tenants
By Jeff Grandfield and Dale Willerton – The Lease Coach | Published June 15th, 2017
Free rent is just one negotiable factor in a commercial lease. To be clear, free rent is a period of time where you are not paying the Base or Minimum Rent (but are, typically, paying your Operating Costs) and you are open for business. Many medical professional tenants confuse this ...
June 13th, 2017
Modifier GY for Chiropractic
By ChiroCode | Published June 13th, 2017 - Last Review/Update January 31st, 2019
Q. Is there a modifier that can be added on to CPT codes to show we performed the service even though they are bundled charges or Medicare doesn't pay for them? For example 97140 billed to BCBS or 99202 billed to Medicare. Is the GY modifier for all insurance companies or just Medicare?
May 22nd, 2017
Maintenance Visit Documentation
By Dr Evan Gwilliam | Published May 22nd, 2017 - Last Review/Update January 31st, 2019
What is required for documenting a maintenance visit for a Medicare beneficiary?
Watch this video by Dr. Evan Gwilliam for his thoughts.
ChiroCodeQ&A_maintenance visit from Innoventrum on Vimeo.
ChiroCode Q&A "Maintenance Visit Documentation" With Dr. Evan Gwilliam. https://vimeo.com/208521720
...
April 28th, 2017
Can I be Forbidden from Billing 99204 or 99214?
By ChiroCode | Published April 28th, 2017 - Last Review/Update January 31st, 2019
Q: An insurer told me that chiropractors cannot bill 99204 or 99214 because those exams "require a level of decision making that would typically only occur in an emergency room." Is this true? Do I have any recourse?
March 29th, 2017
National Association of Chiropractic Attorneys (NACA) Directory
By | Published March 29th, 2017
National Association of Chiropractic Attorneys (NACA) Directory
Listed by state
March 29th, 2017
Newly Revised "Common Procedure Codes" section in the 2016 ChiroCode DeskBook
By Evan M. Gwilliam, DC MBA BS CPC CCPC NCICS CPC-I CCCPC MCS-P CPMA | Published March 29th, 2017
The force used to create a degree of tension of soft tissues and/or to allow for separation between joint surfaces. The degree of traction is controlled through the amount of force (pounds) allowed, duration (time), and angle of pull (degrees) using mechanical means. Terms often used in describing pelvic/cervical traction ...
March 24th, 2017
Are There any Alternatives for Code 97112 Neuromuscular Re-education?
By ChiroCode | Published March 24th, 2017 - Last Review/Update January 31st, 2019
Q: Are there any alternatives for code 97112 Neuromuscular Re-education? This code is counted toward both Chiropractic and Physical Therapy visits with BCBS, and we want to preserve the insurance benefits.
March 3rd, 2017
Chiropractic Manipulation
By Brandy Brimhall, CPC CPCO CMCO CPMA QCC | Published March 3rd, 2017 - Last Review/Update February 8th, 2019
Q: If a patient is treated with chiropractic manipulation and it is clinically appropriate but doesn't qualify as medically necessary care, what is the proper way to communicate this when billing the insurance company for the service?
February 23rd, 2017
Physician Compensation Fraud Alert
By Wyn Staheli, Director of Research | Published February 23rd, 2017
In June 2015, the Office of Inspector General (OIG) issued a Fraud Alert focused on physicians and compensation arrangements. Providers need to ensure that these arrangements do not violate the Anti-Kickback Statute. Healthcare providers found to have committed fraud are subject to possible criminal, civil and administrative sanctions.
In this alert ...
February 11th, 2017
Podiatry Class Findings
By Wyn Staheli, Director of Research | Published February 11th, 2017
The following modifiers are required when reporting medically necessary routine foot care services per Medicare guidelines:
Q7: One Class A finding
Q8: Two Class B findings
Q9: One Class B and two Class C findings
Appropriate: With foot care (podiatry) codes to indicate covered foot care
Inapproriate:
With any code not related to foot care
When the foot ...
February 8th, 2017
Medicare Conversion Factor
By Wyn Staheli, Director of Research | Published February 8th, 2017
In April of 2015, the Sustainable Growth Rate (SGR) formula which is used to calculate the Medicare Physician Fee Schedule (MPFS) Conversion Factor was repealed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The conversion factor will increase by 0.5% each year until 2019 and ...
February 6th, 2017
Quality Reporting is not Just for CMS
By Wyn Staheli, Director of Research | Published February 6th, 2017
If you thought that quality reporting is just for CMS, you are wrong. Other payers recognize the need to establish quality metrics.
February 6th, 2017
Medicare Revises their Appeals Process
By Wyn Staheli, Director of Research | Published February 6th, 2017
On January 17, 2017, a Final Rule was published in the Federal Register outlining changes to the Medicare Appeals process in an order to streamline procedures and reduce the current backlog of appeals at the third and fourth levels of appeal. This new policy takes effect on March 20, 3017. ...
January 24th, 2017
Code Sets - Health Care Provider Taxonomy Code Set Link
By Raquel Shumway | Published January 24th, 2017
Every Provider needs to know their Health Care Provider Taxonomy Codes. The Taxonomy Codes define the provider type, classification, and area of specialization. We have provided a link and instructions to help you locate your code.
January 23rd, 2017
HIPAA Exempt Offices (Paper)
By Wyn Staheli, Director of Research | Published January 23rd, 2017
It is a common misconception that every doctor’s office is (or must become) a HIPAA covered entity; however, the list of those who still qualify for exemption from HIPAA is rapidly shrinking. There are exceptions to the HIPAA requirements; if a practice sends or receives no transactions electronically, it is ...
January 16th, 2017
Alternative Payment Models (APMs) and Advanced APMs
By Wyn Staheli, Director of Research | Published January 16th, 2017
When CMS Released the NPRM regarding the Quality Payment Program (QPP), it included two payment tracks: MIPS and Advanced Alternative Payment Models (APMs). Accountable Care Organizations (ACOs), Patient Centered Medical Homes, and bundled payment models are some examples of APMs. So how do these payment models differ?
According to a fact sheet ...
January 13th, 2017
Whiplash Damages
By ChiroCode | Published January 13th, 2017 - Last Review/Update January 31st, 2019
Whiplash Damages in Rear-end Collisions - The Patient’s Dilemma:
The rear-end collision is a major cause of cervical spine injuries which often require treatment by chiropractors and other health care practitioners. Claims adjusters trivialize soft tissue injuries [it’s “only” a sprain or strain] but whiplash is real and so are the damages that come with it.
December 12th, 2016
60 Day Final Rule
By Wyn Staheli, Director of Research | Published December 12th, 2016
Effective March 14, 2016, the CMS Final Rule clarifying the standards for handling
overpayments for both Medicare and Medicaid takes effect. Failure to report and
subsequently return an overpayment within 60 days after the overpayment was
“identified” is a violation of the False Claims Act.
October 25th, 2016
Another OIG Report on Chiropractic
By ChiroCode | Published October 25th, 2016 - Last Review/Update March 5th, 2019
On October 19 the Office of Inspector General for Health and Human Services (OIG) released another report on chiropractic. Oddly enough the Wall Street Journal had an article on that report published the day it was released (I wonder how that happened). Read hear to see the results.
September 17th, 2016
Government Healthcare Programs
By Wyn Staheli, Director of Research | Published September 17th, 2016
The Department of Health and Human Services (HHS) oversees all government health care programs. They are administered by various agencies such as the Centers for Medicare & Medicaid Services (CMS), the Veterans Administration (VA) and even at the state level. Here are the basic government programs:
Medicare
Federal Workers’ Compensation
Military and Veterans
Medicaid
Federal ...
August 3rd, 2016
ICD-10 Changes for 2017
By Wyn Staheli, Director of Research | Published August 3rd, 2016
The Centers for Medicare & Medicaid Services (CMS) recently released the Proposed Rule regarding the updates to the ICD-10-CM and ICD-10-PCS code sets for Fiscal Year 2017 which begins October 1, 2016. Comments regarding the proposed ICD changes are due May 6th and CMS has stated that the Final Rule ...
August 3rd, 2016
Handling Multiple Plans
By ChiroCode | Published August 3rd, 2016
If the patient’s spouse or parents have an additional insurance plan, there could be multiple insurance plans which could cover the patient. It is very important to correctly determine which is the primary insurance and which is secondary.
The “birthday rule” can be helpful in establishing the proper coverage. Generally, when ...
August 3rd, 2016
Office Policies - Patient Information
By ChiroCode | Published August 3rd, 2016
Employees need to be responsible for obtaining current and correct data. They should also understand that claims with missing or inaccurate patient information are delayed or denied. Some policy examples are:
• Information for the subscriber(s) of the insurance coverage should also be obtained.
• A photocopy of both front and back ...
August 3rd, 2016
New Patient Initial Visit
By ChiroCode | Published August 3rd, 2016
When the patient arrives, it is important to ensure that all forms are properly completed and signed. If they have not already completed the forms online or in the Welcome Packet, give them time to fill them out. Pay particular attention to the following:
• Make copies of their insurance cards, ...
August 3rd, 2016
Write Off Disallowed Amount, Bill Patient
By ChiroCode | Published August 3rd, 2016
The 2016 ChiroCode Deskbook teaches you how to write off disallowed amounts!
Once the claim has been adjudicated and an Explanation of Benefits (EOB) has been received, the disallowed amounts (if required by contract or law) should be deducted from the patient account to accurately reflect their “patient portion.” Only bill the patient ...
August 3rd, 2016
Annual and Lifetime Limits
By ChiroCode | Published August 3rd, 2016
In the 2016 ChiroCode Deskbook, learn about how the 2014 Patient Protection and Affordable Care Act (PPACA) changed insurance coverage policies!
Beginning January 1, 2014, the Patient Protection and Affordable Care Act (PPACA) changed the rules regarding annual and lifetime limits. Insurance companies can no longer set lifetime limits on “Essential ...
August 3rd, 2016
Consumer Driven Health Care Options
By ChiroCode | Published August 3rd, 2016
In the 2016 Chirocode Deskbook learn about Health Savings Accounts, Medicare Medical Savings Accounts, health Reimbursement Arrangement, and other things such as the Multiple-Employer Welfare Arrangements (MEWA)!
Multiple-Employer Welfare Arrangements (MEWA).
MEWA is a type of plan, established by ERISA and regulated by the PPACA, in which two or more unrelated employers, including ...
August 3rd, 2016
Look Before You Leap
By ChiroCode | Published August 3rd, 2016
The 2016 ChiroCode Deskbook includes policies from the American Chiropractic Association regarding the difference in healthcare discount programs. It can help you select the right healthcare discount program specific to your needs!
Not all healthcare discount programs are the same. The Federal Trade Commission (FTC) is warning consumers to carefully evaluate these programs. ...
August 3rd, 2016
1500 Claim Form Tips
By ChiroCode | Published August 3rd, 2016
The following rules for the 1500 claim form are excerpts from NUCC and Medicare instructions, but they are generally universal and apply to claims submitted either electronically or on paper. Please note that payment rules can change frequently for any payer, so consult with specific insurance payers for their adaptations.
The ...
August 3rd, 2016
Financial Hardship Policy
By ChiroCode | Published August 3rd, 2016
The 2016 Chirocode Deskbook offers advice on waivers!
It is improper and illegal to waive co-payments and/or deductibles. For this reason, if you wish to offer some sort of assistance to a patient, the proper way to do so is through an official “Financial Hardship Policy”.
Caution is advised when implementing hardship waivers. ...
August 3rd, 2016
When can I use “unspecified” codes? What about “other”?
By Dr. Evan Gwilliam | Published August 3rd, 2016
The official guidelines for ICD-10-CM define the conventions used in the code set. In section 1.A.6, we learn the following about some common abbreviations in the Tabular List:
August 3rd, 2016
Billing Units
By Wyn Staheli, Director of Research | Published August 3rd, 2016
Are you billing units correctly? This article outlines important considerations to ensure that claims are submitted properly.
July 28th, 2016
Using Leins in Personal Injury Cases
By | Published July 28th, 2016 - Last Review/Update January 25th, 2017
Using Liens in PI Cases
When it comes to getting paid on PI cases, few documents and protocols are as important as those relating to a well drafted financial policy, along with a set of unalterable financial protocols (at least not easy to change). With these in place, you are ...
July 5th, 2016
Q&A: We just learned that for Meaningful Use attestation, we have to complete a Security Risk Assessment. What is that and how do we do it?
By ChiroCode | Published July 5th, 2016 - Last Review/Update March 4th, 2019
Q&A:
We just learned that for Meaningful Use attestation, we have to complete a Security Risk Assessment. What is that and how do we do it?
June 27th, 2016
Are There Codes to Idenitfy the Left or Right Side of the Spine?
By Brandy Brimhall | Published June 27th, 2016
Q: We cannot find codes to identify the left or right side of the spine, such as with low back pain. Do we add digits 1 or 2 to the code to clarify left or right?
A: No. Codes pertaining to the spine are not specific to laterality. The codes do ...
June 23rd, 2016
Commercial Lease Assignments for Chiropractic Tenants
By Jeff Grandfield and Dale Willerton | Published June 23rd, 2016
When The Lease Coach speaks at chiropractic conventions (such as Parker Seminars in Las Vegas), we are magnets for commercial leasing-related questions. Among the most common are concerns relating to assigning or transferring a Lease Agreement. As we explain in our new book, Negotiating Commercial Leases & Renewals For Dummies, ...
June 23rd, 2016
What Are Unproven, Investigational or Experimental Procedures?
By Brandy Brimhall CPC CMCO CPCO CCCPC CPMA | Published June 23rd, 2016
Many specialties, including chiropractors, perform services that may be deemed "experimental, investigational and unproven." Individual payer coverage determinations, as well as state boards, generally offer specific information defining this type of procedure and any other notice or guideline that providers must be aware of and adhere to.The terms "unproven, experimental ...
June 21st, 2016
Voluntary Overpayments
By Wyn Staheli, Director of Research | Published June 21st, 2016
When a claim has been determined to be paid more than the allowed amount, it is considered an overpayment. The action to be taken depends on how the overpayment is discovered. This article covers voluntary overpayment refund procedures as well as a Voluntary Overpayment Form.
June 15th, 2016
Mastering Medicare: When Opting Out is not an Option
By Dr. Ray Foxworth, Certified Medical Compliance Specialist and President of ChiroHealthUSA | Published June 15th, 2016 - Last Review/Update March 5th, 2019
Unlike MDs and DOs, chiropractors may not opt out of Medicare.
When it comes to Medicare, providers and patients alike feel like beating their heads against the wall. Signing up to be a provider or a patient is confusing, understanding what is covered is confusing and just about the time you think you have it figured out, you receive a notice that suggests you don’t.
The hassles of Medicare certainly validate any sane person questioning whether they should see a Medicare patient, but with the rising number of Medicare patients in the US do you really want to limit your patient base?
June 9th, 2016
Understanding and Using Taxonomy Codes to Maximize Reimbursement
By | Published June 9th, 2016
Taxonomy codes are used by insurers as indicators of legal scope of practice. Scope of practice is key to getting reimbursed under the Affordable Care Act or ObamaCare. However, Most providers will only choose one taxonomy code to describe their training. This limits their scope of practice. To maximize scope ...
June 7th, 2016
HIPAA Helps and FAQs
By Raquel Shumway | Published June 7th, 2016
The Health Insurance Portability and Accountability Act (HIPAA) has been around for quite some time. There are many misconceptions about HIPAA compliance that our office still gets calls about. This page is to help clear up some of these misconceptions.
May 26th, 2016
Groupon: Is it worth the risk?
By Dr. Ray Foxworth, Certified Medical Compliance Specialist and President of ChiroHealthUSA | Published May 26th, 2016 - Last Review/Update March 5th, 2019
Our team is frequently asked if it is legal for chiropractic offices to offer coupons or Groupons. We’re not allowed, as a profession, to dramatically discount our services, offer free treatments, or provide gifts or free meals for potential patients. Any one of these things can be considered an “inducement.” Practices that improperly induce patients to seek care or services, for example, by providing coupons for care or supplies, may find that they are in violation of the law if they aren’t careful.
So what will that mean to you and your practice? It isn’t pretty.
May 19th, 2016
Your Reasons to Delay Compliance Implementation are GONE!
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published May 19th, 2016
ChiroCode has proudly served chiropractic for more than 30 years and continues to work to bring the most necessary, affordable, and user friendly products and services to practices. Increased regulation has hindered practices by creating uncertainty around the nature of guidelines and the expensive penalties that arise from non-compliance with ...
May 13th, 2016
Using the Right Diagnosis
By Omega Renne, CPC, CPCO, CPMA, CEMC, CIMC | Published May 13th, 2016 - Last Review/Update August 16th, 2017
One of the hardest parts when reviewing a medical record for coding or auditing is the determination of what conditions were addressed. Any condition that is taking into account or affects patient care, treatment or management should be documented and ultimately coded. However, the documentation still needs to support that ...
May 3rd, 2016
Using the SBIRT
By Wyn Staheli, Director of Research | Published May 3rd, 2016
Screening, Brief Intervention, and Referral to Treatment (SBIRT) services are an effective tool for healthcare providers to identify, reduce, and prevent problematic substance use disorders. Healthcare practices can help their patients and improve their integrated care standards with the proper use of the SBIRT.
May 3rd, 2016
Provider/Patient Dynamic Changes as Result of High Deductible Plans
By Wyn Staheli, Director of Research | Published May 3rd, 2016
High-deductible plans are changing the way patients utilize medical services, therefore, providers must also adapt by adjusting both their communication and billing practices to keep pace with these changes.
April 30th, 2016
Phase 2 of OCR HIPAA Audits Begins
By Wyn Staheli, Director of Research | Published April 30th, 2016
Phase 2 of HIPAA audits have begun. What do you need to know?
April 13th, 2016
Telehealth Basics
By Wyn Staheli, Director of Research | Published April 13th, 2016
Telehealth and telemedicine are covered for many payers for services such as consultation, office visits, individual psychotherapy, and pharmacologic management delivered via a telecommunications system.
April 13th, 2016
Lack of Business Associate Agreement (BAA) Costs Non-Profit 1.55 Million
By Wyn Staheli, Director of Research | Published April 13th, 2016
Failure to have a properly executed Business Associate Agreements (BAA) costs one organization $1.55 Million. In today's highly technological environment, it is too easy to skip the necessary precautions and easy for electronic devices to get lost or stolen. Are you prepared?
April 6th, 2016
HIPAA Violations - The Process Is The Answer
By Instacode Institute | Published April 6th, 2016
It's not just the names and addresses that matter -- It's the compliance. If you can demonstrate that you are hleping yourself to maintain HIPAA compliance by careful documentation and proper procedures, you can go a long way toward avoiding being fined by the HIPAA squads.
Complete & Easy HIPAA Compliance is a clear, simple “Just help me do what I have to do!” workbook that contains all the things the designated security officer must do to instantiate a robust HIPAA compliance program. It comes complete with over 45 forms and letters which can be used to state the office policies, spell out procedures, and ensure that each patient will be protected in their rights under HIPAA policy. It also can help demonstrate that a compliance program is in progress.
April 5th, 2016
Voluntary Disclosure - Look Before You Leap
By ChiroCode | Published April 5th, 2016
Occasionally providers are faced with the need to assess the option of making a voluntary disclosure to the government. Here are steps that every provider should consider before disclosing information to the government.
March 16th, 2016
Protected Health Information De-Identification Standards
By Instacode Institute | Published March 16th, 2016 - Last Review/Update January 27th, 2017
This article contains detailed information on the OCR guidance regarding the de-identification of Protected Health Information (PHI). Avoid HIPAA violations and learn specifically what de-identification is.
March 7th, 2016
Diagnosis Codes for Cervical Kyphosis
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published March 7th, 2016
Coding for a reduced cervical curve is a little tricky in ICD-10. This article explores the choices and issues around this diagnosis.
March 4th, 2016
What is an 'Other Qualified Healthcare Professional'?
By Wyn Staheli | Published March 4th, 2016
What's the difference between a physician, an other qualified healthcare professional, clinical staff and individual.
February 24th, 2016
Employee Exclusions Screenings Must be High Priority
By Wyn Staheli | Published February 24th, 2016
Many healthcare organizations are not aware of how critically important it is to screen their employees against ALL state and federal exclusions databases. This article has important information for organization to ensure compliance.
February 15th, 2016
Unified Program Integrity Contractors (UPIC)
By InstaCode Institute | Published February 15th, 2016
CMS is developing a new Unified Program Integrity Contractor (UPIC) program to consolidate Medicare and Medicaid reviews. This consolidation of the Medicaid Integrity Contractors (MICs) and the Medicare Zone Program Integrity Contractors (ZPICs) could relieve some of the overlap and burdens under the current systems.
January 6th, 2016
6 ways to stop filing duplicate Medicare claims - Duplicates could expose your practice to fraud investigation
By | Published January 6th, 2016
Whenever a Medicare Administrative Contractor (MAC) releases a list of the top reasons for claims denials, the list almost never fails to include duplicate claims. When the MAC perceives the claim to be a duplicate, based typically on a match of the patient identifying information, furnishing...
October 20th, 2015
Finding Strain and Sprains in ICD-10-CM
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published October 20th, 2015
There has been some confusion on Sprain vs. Strain and how to find them in ICD-10-CM. They are now split in two separate code ranges and Injury is now related to the anatomic location specific to the injury.
It will help to remember the following information when searching for Strains vs. ...
October 5th, 2015
Reporting Laterality Still Requires Modifiers
By Wyn Staheli, Director of Research | Published October 5th, 2015
One of the significant coding changes with ICD-10-CM was including laterality within the code itself. This concept should help reduce billing errors and claim denials. Interestingly, CMS issued a statement regarding the reporting of laterality in their provider newsletter (emphasis added).
Implementation of ICD-10-CM will not change the reporting of Current Procedural Terminology ...
August 19th, 2015
Cervical diagnosis Using ICD-10 - July 2013
By | Published August 19th, 2015 - Last Review/Update January 27th, 2017
By Dr. Evan Gwilliam
Using a Medicare Local Coverage Determination (LCD), and the General Equivalence Mappings (GEMs) as a starting point, I will attempt in this article to predict which ICD-10-CM codes will be approved for the secondary cervical diagnoses which Medicare uses now. (By the way, I just use the ...
August 19th, 2015
Chiropractic Listed as Focal Point in 2015 OIG Work Plan
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published August 19th, 2015 - Last Review/Update January 30th, 2017
With the recent release of the 2015 OIG Work Plan, many providers and facilities are reviewing the content to learn which areas of interest pertaining to their specialty will be points of interest for federal auditing programs for the 2015 Fiscal Year. The information contained in this Work Plan addresses the ...
August 19th, 2015
How do I know which seventh character to use with sprain and strain codes in ICD-10?
By Evan M. Gwilliam | Published August 19th, 2015
The sprain and strain codes offer three choices for the final character:
A - initial encounter
D - subsequent encounter
S - sequela
August 10th, 2015
Manipulation Under Anesthesia in the Office
By | Published August 10th, 2015 - Last Review/Update January 27th, 2017
When manipulation under anesthesia is done in the office instead of a facility, code selection is different.
August 10th, 2015
Opting out of Medicare Electing to Order/Certify Items and Services to Medicare Beneficiaries
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published August 10th, 2015
Physicians and practitioners who do not wish to enroll in the Medicare program may “opt-out” of Medicare. This means that neither the physician, nor the beneficiary submits the bill to Medicare for services rendered. Instead, the beneficiary pays the physician out-of-pocket and neither party is reimbursed by Medicare. A private ...
August 10th, 2015
Payer Policy is Important
By | Published August 10th, 2015 - Last Review/Update January 27th, 2017
I attended the 2009 AAPC (American Academy of Professional Coders) convention in Las Vegas. Perhaps the most valued lesson relearned there was from Mike Miscoe, CPC, JD. Yes, he is a certified professional coder and an attorney. Mike is one of the most knowledgeable consultants in health care reimbursement that ...
August 10th, 2015
Hardship Discounts
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
What are they and how can I safely create one based on the patient's poverty level?
August 10th, 2015
Lumbar Diagnosis Using ICD-10
By Melinna Giannini | Published August 10th, 2015 - Last Review/Update January 27th, 2017
This article is coming out before the payers have told us which ICD-10 codes will be used for claim submission. However, we have access to the same code set that they do, therefore this is an educated guess at which codes might used by DCs for the lumbar spine. The ...
August 10th, 2015
Chiropractic Tenants – Choosing the Location Where Your Practice will Thrive
By By Jeff Grandfield & Dale Willerton – The Lease Coach | Published August 10th, 2015
As we explain in our new book, Negotiating Commercial Leases & Renewals For Dummies (Wiley, 2013) and when we recently spoke at Parker Seminars in Las Vegas, finding the right location or property for your practice is one of the most important decisions you can make. It’s not always easy, ...
August 10th, 2015
Audit Fighting Tactics
By Tom Necela, DC, CPC, CPMA, CCP-P | Published August 10th, 2015 - Last Review/Update January 27th, 2017
Four Tactics or tips to help you fight back when you are audited or have your claims reviewed. They are effective and easy to use.
August 10th, 2015
Alphabet Soup for Waste and Fraud Inspectors
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
The following are some of the acronyms you would need to know when communicating with auditors:
National Correct Coding Initiative (NCCI) Edits: Use of codes that should not occur on the same day, effectively treating the same area twice.
Medically Unlikely Edits (MUE): Exceeding the anticipated units of service (time spent) for a given HCPCS or CPT code.
Office of the ...
August 10th, 2015
Can Chiropractors Finally Code a "Subluxation" in ICD-10?
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
There is a word that has long been held as sacred to the Chiropractic profession. It is the so-called vertebral “subluxation.” Throughout ICD-9, which is the diagnostic code set used on claims for the last thirty years, the term “subluxation” is used to describe a partial dislocation,” which is not how it is defined by many Chiropractors. Medicare ...
August 10th, 2015
Fill-in Doctor: Locum Tenens
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
It is a common practice for a solo doctor to find someone to cover for them while they are away from the office for a temporary or extended period of time, such as medical leave, or vacation. Some offices fail to code properly for the services rendered by the “fill-in” doctor. When completing the CMS 1500 ...
August 10th, 2015
Can Chiropractors Bill 99211?
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
This code would be used rarely in a chiropractic office. 99211 is a low complexity examination for an established patient. It can be used by chiropractors, but in most instances, it is discouraged.
The 99211 code, also known as the nurse’s code, is not really made for the physician to use. In fact, the AMA, CPT ...
August 10th, 2015
ICD-10 External Cause Codes Tell the Whole Story
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
Beginning October 1, 2015 all claims for health care services in the United States must use ICD‑10 diagnosis codes. ICD‑9 has been the standard since 1979, but has outlived its usefulness. Because of its structure, ICD‑10 provides better data for research and statistical analysis than ICD‑9. Although there is no national mandate to report ...
August 10th, 2015
Appointments, Reminders, Text Messaging, and HIPAA
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
As more and more people are using mobile and wireless devices, a new term - mHealth - has emerged. According to a National Institute of Health consensus group, mHealth is “the use of mobile and wireless devices to improve health outcomes, healthcare services and health research.” Historically, the biggest gaps and HIPAA violations have been linked to ...
August 10th, 2015
Under Promise
By | Published August 10th, 2015 - Last Review/Update January 27th, 2017
Under Promise
Question: When should you recommend the maximum care that a patient might need?Answer: Always
Question: When should you give a patient more care than they need?Answer: Never
I’m standing in line with my five children at a Disneyland attraction called Splash Mountain. After moving slowly forward for about 15 minutes, we get to a sign ...
August 10th, 2015
Adjunctive (Add-On) Codes
By ChiroCode | Published August 10th, 2015 - Last Review/Update January 27th, 2017
Stop losing hard-earned dollars. Too often, dollars are left on the table at billing time. Adjunctive codes for associated services should be added when they are appropriate. Here are a few examples of coding that are often overlooked.
97014 & 97032 Electrical Stimulation Supplies
According to the Relative Value Update Committee (RUC), ...
August 3rd, 2015
Chiropractors - Negotiate a Mid-term Rent Reduction for Your Commercial Lease
By Jeff Grandfield and Dale Willerton - The Lease Coach | Published August 3rd, 2015
When The Lease Coach spoke at Parker Seminars in Las Vegas, we met a number of struggling chiropractors leasing commercial space. These chiropractic tenants desperately need a rent reduction ... right now.
June 29th, 2015
HIPAA Standards for Claims
By Find-A-Code | Published June 29th, 2015
(Rev. 3086, Issued: 10-03-14, Effective: ICD-10: Upon Implementation of ICD-10, ASC X12: January 1, 2012, Implementation ICD-10: Upon Implementation of ICD- 10; ASC X12: November 4, 2014) The standards adopted under HIPAA include both a transaction standard and an implementation guide. The following are the claims transactions and the implementation ...
June 25th, 2015
Certification of Mammography Facilities (Rev. 1387, 04-07-08)
By Jared Staheli | Published June 25th, 2015
The Mammography Quality Standards Act (MQSA) provides specific standards regarding those qualified to perform screening and diagnostic mammograms and how they should be certified. The MQSA requires the Secretary to ensure that all facilities that provide mammography services meet national quality standards. Effective October 1, 1994, all facilities providing screening ...
June 22nd, 2015
Chiropractic Policy Addendum: Maintenance Therapy CR2717
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published June 22nd, 2015 - Last Review/Update August 7th, 2017
The Centers for Medicare & Medicaid Services (CMS) has further defined Chiropractic Maintenance Therapy. Section 2251.3 of the Medicare Carriers Manual (MCM) has been amended to clarify Medicare requirements for treatment of chiropractic therapy.
"MCM 2251.3 Necessity for Treatment.--
A. The patient must have a significant health problem in the form of a neuromusculoskeletal ...
June 10th, 2015
Buying vs. Leasing Commercial Practice Space: Pros and Cons for Chiropractic Tenants
By By: Jeff Grandfield and Dale Willerton – The Lease Coach | Published June 10th, 2015
As we explain in our new book, Negotiating Commercial Leases & Renewals For Dummies, the most common reason tenants lease space instead of buying a location is because 95 percent of all commercial and office space is for lease and not for sale.
If you are in an enviable position ...
May 12th, 2015
Selecting the Best Location for Your Chiropractic Office
By ChiroCode | Published May 12th, 2015 - Last Review/Update May 13th, 2016
By: Jeff Grandfield and Dale Willerton – The Lease Coach
When we do site selection for a chiropractor, we are not looking for the cheapest location we can find, but instead the location that will enable the doctor to maximize his or her patient volume. As we explain in our new ...
May 7th, 2015
Personal Injury Information by Find-A-Code
By Find-A-Code | Published May 7th, 2015 - Last Review/Update June 9th, 2016
Personal Injury is an complicated subject as it relates to medical services. This page contains helpful information as an additional resource to Find-A-Code's specialty-specific Reimbursement Guides.
April 24th, 2015
Have you been excluded from Medicare?
By Dr. Chris Andersn | Published April 24th, 2015 - Last Review/Update June 9th, 2016
Compliance is an issue that you should look at as an expedition rather than an endpoint. Board complaints can be a terrifying ordeal, especially if you don’t keep up on compliance in your clinic. Board complaints are something that you have to expect to happen but you can turn that ...
March 30th, 2015
Selecting the Best Location for Your Chiropractic Office
By | Published March 30th, 2015 - Last Review/Update June 9th, 2016
By: Jeff Grandfield and Dale Willerton – The Lease Coach
When we do site selection for a chiropractor, we are not looking for the cheapest location we can find, but instead the location that will enable the doctor to maximize his or her patient volume. As we explain in our new ...
March 24th, 2015
Instructions for: P.A.R.T. Documentation Form
By | Published March 24th, 2015 - Last Review/Update April 9th, 2018
Patient Portion
The first part of the form is for the patient to complete. The date, name and age are completed, along with a brief description of why they came in for a visit.
Pain
“X’s” are placed on areas causing pain. Qualify the pain with a letter, i.e., “A“ for “Ache.”
The patient ...
March 17th, 2015
Patient Information Form
By Raquel Shumway | Published March 17th, 2015 - Last Review/Update June 9th, 2016
We have two different samples for Patient Information Forms. We suggest that you review both and determine which best fits your practice model. Form #2 is editable so it could be easily modified for your organization. Both forms provide the basic information necessary for all types of healthcare practices.
Instructions for: Patient ...
February 26th, 2015
Chiropractic Billing 101: A Basic Guide
By | Published February 26th, 2015 - Last Review/Update January 27th, 2017
Director of Communications, ChiroCode
In my 20 years of professional bull riding I have had many highs and lows. There were times when the rankest of bulls couldn’t throw me and times when I couldn’t ride a rocking chair. When in a slump, what always worked for me, and for the ...
February 23rd, 2015
Q & A: Why is Medicare Denying Claims?
By | Published February 23rd, 2015 - Last Review/Update March 9th, 2016
Q: We have recently enrolled with Medicare and treat only a few patients. However, those claims are being denied. Can you help me to understand why this might be happening?
A: First, I would recommend you carefully review your Medicare Remittance Advice as that will identify the reason Medicare is denying your ...
February 13th, 2015
Chiropractic Services - Aetna Clinical Policy Bulletin
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published February 13th, 2015 - Last Review/Update March 1st, 2016
AETNA
Clinical Policy Bulletin: Chiropractic Services
Number: 0107
http://www.aetna.com/cpb/medical/data/100_199/0107.html
Policy
Note: Some plans have limitations or exclusions applicable to chiropractic care. Please check benefit plan descriptions for details.
Aetna considers chiropractic services medically necessary when all of the following criteria are met:
The member has a neuromusculoskeletal disorder; and
The medical necessity for treatment is clearly documented; and
Improvement is ...
February 10th, 2015
MAC Jurisdictions Resources
By | Published February 10th, 2015 - Last Review/Update February 18th, 2016
The Centers for Medicare & Medicaid Services (CMS) uses a network of contractors called Medicare Administrative Contractors (MAC) to process Medicare claims, enroll health care providers in the Medicare program and educate providers on Medicare billing requirements. MACs also handle claims appeals and answer beneficiary and provider inquiries. Even though ...
February 9th, 2015
Encryption
By Wyn Staheli, Director of Research | Published February 9th, 2015 - Last Review/Update June 9th, 2016
How secure is your computer? Do you have a password on your computer? Do you have the automatic log offs turned on? Is your computer encrypted? Are your off-site storage files encrypted?
This document is designed to give some basic information about making your office a little more secure. It is not ...
February 4th, 2015
Virtual Cards
By Wyn Staheli | Published February 4th, 2015 - Last Review/Update June 9th, 2016
Sometimes called "disposable," "temporary," or "one-time use" numbers, a virtual credit card number is "like putting a wall" between your transaction and your regular account, says Steve Kenneally, vice president of the American Bankers Association. Although these cards can protect the cardholder from fraud, the use of virtual cards as ...
February 3rd, 2015
Personal Injury Information by ChiroCode
By ChiroCode | Published February 3rd, 2015 - Last Review/Update February 1st, 2017
Personal Injury is an complicated subject for all healthcare providers, including chiropractic physicians. This page contains helpful information as an additional resource to the ChiroCode DeskBook.
See Chapter 1-Insurance of the ChiroCode DeskBook for explanations and definitions of important terms and subjects related to Personal Injury.
February 3rd, 2015
Health Care Reform
By Wyn Staheli, Director of Research | Published February 3rd, 2015 - Last Review/Update June 9th, 2016
Even though the health care system in the United States is one of the most expensive per capita in the world, we have a dismally low quality of care ranking. Healthcare reform (HCR) in its simplest terms is addressing these shortcomings in order to improve healthcare coverage, delivery, policies, or ...
January 30th, 2015
What NOT to Ask Candidates in a Job Interview
By | Published January 30th, 2015 - Last Review/Update June 9th, 2016
Conducting a job interview for potential new employees is a common occurrence, yet is often done in a manner of disorganization. Employers are frequently asking questions that shouldn't be asked and neglecting to ask those questions that may be more essential for conducting a proper interview. Federal and state laws ...
January 26th, 2015
Documentation Resources
By ChiroCode | Published January 26th, 2015 - Last Review/Update January 30th, 2017
Documentation is essential to establishing medical necessity and the level of services provided to the patient. Treatment plans and outcome assessments are crucial elements to thorough documentation.
This page is only a general listing of documentation resources for chiropractic. More thorough and detailed explanations are found in Section D-Documentation in the ...
January 23rd, 2015
Chiropractic Listed as Focal Point in 2015 OIG Work Plan
By | Published January 23rd, 2015 - Last Review/Update January 30th, 2017
With the recent release of the 2015 OIG Work Plan, many providers and facilities are reviewing the content to learn which areas of interest pertaining to their specialty will be points of interest for federal auditing programs for the 2015 Fiscal Year. The information contained in this Work Plan addresses ...
January 8th, 2015
Discounts by ChiroCode
By ChiroCode | Published January 8th, 2015 - Last Review/Update January 30th, 2017
All healthcare providers need to be aware that there are both appropriate and inappropriate ways to discount your fees. Both state and federal laws can impact your practice financial policy regarding fee discounts. Additionally, we recommend carefully reviewing Section F-Fees of the ChiroCode DeskBook for important information on fee schedules and ...
January 8th, 2015
Chiropractors - Negotiate Your Commercial Lease “For Dummies”
By | Published January 8th, 2015 - Last Review/Update March 9th, 2016
By: Dale Willerton – The Lease Coach
For many chiropractors, negotiating a good lease or lease renewal against an experienced agent or landlord can be a challenge. While a chiropractor focuses on patient care, savvy real estate agents and brokers are specialized sales people. Their job is to sell chiropractic tenants ...
December 30th, 2014
Understanding TOS Discounts and DMPOs
By | Published December 30th, 2014 - Last Review/Update March 9th, 2016
Time-of-Service (TOS) discounts are a common occurrence in chiropractic. What is often assumed is that if insurance isn't involved, there are no rules that apply.
Unfortunately, this is a myth that can become costly to practices and damage provider/patient relationships. So read on to learn the facts about TOS discounting and ...
December 15th, 2014
OIG Reports Success in Efforts to Prevent Fraud, Waste, and Abuse
By | Published December 15th, 2014 - Last Review/Update January 30th, 2017
The HHS OIG Work Plan for the 2015 Fiscal Year has recently been released. In this publication, the OIG addresses the accomplishments made from the previous year's Plan as well as the objectives that will be of interest for the coming new year. Accomplishments for the 2014 Fiscal Year are ...
December 3rd, 2014
Coding for Laser Therapy
By | Published December 3rd, 2014 - Last Review/Update January 30th, 2017
The Rule of Coding: Service Codes define "what" you do; diagnosis codes define "why" you're doing it. Billing for laser or any other service must be properly defined and supported by both a service code and a diagnosis code.
Coverage for laser, as with any other service, is strictly dependent upon the ...
December 1st, 2014
Q & A: Establishing a Multi-Disciplinary Practice and Being Legal
By | Published December 1st, 2014 - Last Review/Update January 30th, 2017
Q: How do you add another provider type such as a Nurse Practitioner to your practice to provide additional services to patients and legally bill for those services under their license?
A: Multi-disciplinary practices are under scrutiny at the moment by ZPIC, CMS and State Boards. For your reference, just below, there ...
November 25th, 2014
Have you checked your QRUR to find out if you qualify for a CMS bonus (or penalty)?
By | Published November 25th, 2014 - Last Review/Update January 30th, 2017
What? You've never heard of a QRUR?
You have probably heard about Meaningful Use (MU) and penalties that kick in for those who did not attest. And the Physician Quality Reporting System (PQRS) with penalties for those who did not successfully report on at least one patient. The new one ...
November 24th, 2014
Conducting a Gap Analysis for Your Documentation & Billing Systems
By | Published November 24th, 2014 - Last Review/Update January 30th, 2017
What is a Gap Analysis?
A Gap Analysis is a process by which a practice conducts a baseline assessment of the company's coding, billing, operations, and business practices. The objective of a Gap Analysis is to ensure that the practice is in full compliance with applicable legal and ethical requirements. This ...
November 21st, 2014
Coding for Laser Therapy
By | Published November 21st, 2014 - Last Review/Update January 30th, 2017
The Rule of Coding: Service Codes define "what" you do; diagnosis codes define "why" you're doing it. Billing for laser or any other service must be properly defined and supported by both a service code and a diagnoses code.
Coverage for laser, as with any other service, is strictly dependent upon the ...
November 21st, 2014
Understanding TOS Discounts and DMPOs
By | Published November 21st, 2014 - Last Review/Update January 30th, 2017
Time-of-Service (TOS) discounts are a common occurrence in chiropractic. What is often assumed is that if insurance isn't involved, there are no rules that apply.
Unfortunately, this is a myth that can become costly to practices and damage provider/patient relationships. So read on to learn the facts about TOS discounting and ...
November 21st, 2014
A Practice's Responsibility in Managing Medical Expenses
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published November 21st, 2014 - Last Review/Update January 30th, 2017
Medical expenses are one of the largest expenses in many United States households. Medical bills and insurance remittance are also possibly the most difficult of all bills for patients to interpret and understand.Â
Of course, this lack of understanding often has a negative impact on many things, such as: provider/patient relationship, provider ...
November 21st, 2014
Establishing a Multi-Disciplinary Practice and Being Legal
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published November 21st, 2014 - Last Review/Update January 30th, 2017
Q: How do you add another provider type such as a Nurse Practitioner to your practice to provide additional services to patients and legally bill for those services under their license?
A: Multi-disciplinary practices are under scrutiny at the moment by ZPIC, CMS and State Boards. For your reference, just below, there ...
November 19th, 2014
Understanding RAC
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published November 19th, 2014 - Last Review/Update January 30th, 2017
Recovery Audit Contractors, also known as RAC, is a program that seeks to identify and correct improper payments for services provided to Medicare Parts A & B beneficiaries. This includes both recoupment of overpayments and corrected distribution of underpayments made by CMS.  RAC began in 2005 as a three-year demonstration project consisting ...
November 17th, 2014
Conducting a Gap Analysis for Your Documentation & Billing Systems
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published November 17th, 2014 - Last Review/Update January 30th, 2017
What is a Gap Analysis?
A Gap Analysis is a process by which a practice conducts a baseline assessment of the company's coding, billing, operations, and business practices. The objective of a Gap Analysis is to ensure that the practice is in full compliance with applicable legal and ethical requirements. This ...
November 7th, 2014
Q & A: 97022 and Dry Hydromassage
By | Published November 7th, 2014 - Last Review/Update January 30th, 2017
Is it appropriate to use 97022, whirlpool, to report dry hydromassage?
The CPT code 97022 is defined simply as “Application of a modality to 1 or more areas; whirlpool”. The CPT book does not expand on the code. However, in 2002, the CPT manual added this phrase to the general guidelines:
Do not select a ...
November 5th, 2014
Is Modifier -59 going away?
By | Published November 5th, 2014 - Last Review/Update January 30th, 2017
Anyone who uses modifier 59 needs to be aware that due to problems with the incorrect usage of this modifier (which by the way is also revised for 2015,) CMS has added four new HCPCS modifiers. An announcement by CMS stated that "CMS is establishing four new HCPCS modifiers to define subsets of the -59 modifier, a modifier used to define a “Distinct Procedural Service.”
The new codes are:
October 24th, 2014
Q & A: Is it a HIPAA Violation to Email Patients?
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published October 24th, 2014 - Last Review/Update January 30th, 2017
Straight from the Office of Civil Rights:
Q: Does the HIPAA Privacy Rule permit health care providers to use e-mail to discuss health issues and treatment with their patients?
A: Yes. The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, with their patients, provided they apply ...
October 22nd, 2014
Q & A: 97022 and Dry Hydromassage
By | Published October 22nd, 2014 - Last Review/Update January 27th, 2017
Is it appropriate to use 97022, whirlpool, to report dry hydromassage?
The CPT code 97022 is defined simply as “Application of a modality to 1 or more areas; whirlpool”. The CPT book does not expand on the code. However, in 2002, the CPT manual added this phrase to the general guidelines:
Do ...
October 16th, 2014
Is Compliance a Dirty Word?
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published October 16th, 2014 - Last Review/Update January 23rd, 2017
In October of 2000 in the Federal Register the Office of the Inspector General (who investigates fraud against the federal government on behalf of the Department of Health and Human Services) offered general guidelines for health care facilities to set up a “Compliance Program”. This advice has long been pushed ...
October 16th, 2014
Chiropractic is Listed as a Priority in the 2014 OIG Work Plan...Find Out Why
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published October 16th, 2014 - Last Review/Update January 30th, 2017
Each year the Office of Inspector General (OIG) issues an updated work plan which outlines the objectives and enforcement priorities for each new year. For Medical providers, including Chiropractic, this information is necessary to review and be familiar with so we may evaluate our own practice systems to ensure compliance ...
October 16th, 2014
ABN FAQ for Chiropractic Care
By | Published October 16th, 2014 - Last Review/Update November 29th, 2017
What is the ABN form used for?
The Advanced Beneficiary Notice of Non-Coverage (ABN) is the Notice of Liability that is required to be provided to Medicare patients in the event that the service(s) rendered to them are expected to not be covered. For chiropractic, reason for non-coverage is generally due ...
October 3rd, 2014
Good Attorneys and Bad Attorneys
By | Published October 3rd, 2014 - Last Review/Update January 27th, 2017
A “good” lawyer could be a “bad” lawyer when it come to your unique problem(s). Never ask or expect any professional person (doctor or lawyer) to perform beyond their scope of practice or ability. A college law degree and passing the state bar, is only a license which permits them ...
September 26th, 2014
Patient Electronic Access Tipsheet - Measure Compliance
By Christine Woolstenhulme, QCC, QMCS, CPC, CMRS | Published September 26th, 2014 - Last Review/Update January 30th, 2017
MEASURE COMPLIANCE - Meeting the Patient Electronic Access Objective
Starting in 2014, CMS requires that providers participating in both Stage 1 and Stage 2 of the EHR Incentive Programs must meet the Patient Electronic Access objective, which gives patients access to their health information in a timely manner. Providers participating in ...
September 15th, 2014
Medicare Definition of Timed Codes
By Wyn Staheli, Director of Research | Published September 15th, 2014 - Last Review/Update July 12th, 2016
Many procedure codes are considered "timed codes," that is, the number of units are determined by the amount of time spent performing the service. Medicare Claims Processing Manual, Chapter 5 clarification included here.
September 15th, 2014
Can Chiropractors Bill 99211?
By | Published September 15th, 2014 - Last Review/Update January 30th, 2017
This code would be used rarely in a chiropractic office. 99211 is a low complexity examination for an established patient. It can be used by chiropractors, but in most instances, it is discouraged.
The 99211 code, also known as the nurse's code, is not really made for the physician to use. In fact, the AMA, ...
September 11th, 2014
According to HIPAA, who are my Business Associates?
By Brandy Brimhall, CPC, CMCO, CCCPC, CPCO, CPMA | Published September 11th, 2014 - Last Review/Update January 30th, 2017
Providers work with many different groups and many of them have some interaction with Protected Health Information (PHI). In an effort to help us understand who qualifies as Business Associates the Department of Health & Human Services has provided some resources.
But first … what is PHI or individually identifiable health information? ...
September 9th, 2014
Total Practice Resources LLC is now part of ChiroCode Inc.
By | Published September 9th, 2014 - Last Review/Update January 30th, 2017
Total Practice Resources LLC is now part of ChiroCode Inc.
CONTACT: Dr Evan Gwilliam , Vice President ChiroCode Inc, 602-944-9877 ext 117 drg@chirocode.com
CONTACT: Brandy Brimhall, owner of Total Practice Resources, 602-944-9877 ext 120 brandy.brimhall@chirocode.com
FOR IMMEDIATE RELEASE - Sept 10, 2014
Spanish Fork, Ut.— ChiroCode Inc announces today Total Practice Resources will become ...
September 9th, 2014
Compliance Specialists
By | Published September 9th, 2014
Compliance specialists are responsible for monitoring health and human services program operations for compliance with federal and state regulations and standards in order to promote health and safety, assure that public services are delivered properly, or prevent fraud. Areas assessed may include service delivery, eligibility determination and payment, medical reimbursement, ...
August 28th, 2014
Good Attorneys and Bad Attorneys
By | Published August 28th, 2014 - Last Review/Update January 30th, 2017
A “good” lawyer could be a “bad” lawyer when it come to your unique problem(s). Never ask or expect any professional person (doctor or lawyer) to perform beyond their scope of practice or ability. A college law degree and passing the state bar, is only a license which permits them ...
July 31st, 2014
Fill In Doctor: Locum Tenens
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published July 31st, 2014 - Last Review/Update January 25th, 2017
It is a common practice for a solo doctor to find someone to cover for them while they are away from the office for a temporary or extended period of time, such as medical leave, or vacation. Some offices fail to code properly for the services rendered by the “fill-in” ...
July 31st, 2014
Can Chiropractors Bill 99211?
By | Published July 31st, 2014 - Last Review/Update January 25th, 2017
This code would be used rarely in a chiropractic office. 99211 is a low complexity examination for an established patient. It can be used by chiropractors, but in most instances, it is discouraged. The 99211 code, also known as the nurse's code, is not really made for the physician to use. ...
July 31st, 2014
GP Modifier for Physio Therapy Services
By Evan M. Gwilliam DC MBA BS CPC CCPC QCC CPC-I MCS-P CPMA CMHP | Published July 31st, 2014 - Last Review/Update January 25th, 2017
The -GP modifier needs to be appended to physio-therapy codes when submitting Medicare claims. However, be aware of differing policies for different types of payers. Chiropractors typically use the following Physical Medicine codes from the CPT book: 97010 thru 97799 (except for 97597-97610 for active wound care management). The current ...
July 24th, 2014
Are Medicare fees going up? Or down?
By | Published July 24th, 2014 - Last Review/Update January 29th, 2016
Are Medicare fees going up? Or down? Results for the following:
Sequestration
Chiropractic Demonstration Project
Electronic Health Record/Meaningful Use
Physician Quality Reporting System - PQRS
Value-Based Modifier
July 24th, 2014
Are Medicare fees going up? Or down?
By | Published July 24th, 2014 - Last Review/Update January 25th, 2017
PAMA (up 0.5%)
On April 1, 2014, President Obama signed into law the Protecting Access to Medicare Act of 2014 (PAMA). Within this law, Congress instituted changes that went into effect on July 1, 2014. The law provided for a 0.5% update for claims with dates of service on or after ...
July 16th, 2014
Windows XP and HIPAA Non-compliance
By Wyn Staheli, Director of Research | Published July 16th, 2014 - Last Review/Update January 25th, 2017
For anyone who is not a computer techie, the announcement by Microsoft about discontinuing support for Windows XP may not mean much. However, from a HIPAA perspective, this is very important information because Section 164.308(a)(5)(ii)(B) of the HIPAA Security Rules includes an 'addressable' requirement of Protection from Malicious Software where ...
May 28th, 2014
OSHA Penalty Calculation Information
By Wyn Staheli, Director of Research | Published May 28th, 2014 - Last Review/Update January 25th, 2017
This article contains information from OSHA which outlines the penalty structure for OSHA violations. It includes a list of different types of violations that may be cited and the penalties that may be proposed by the area director. Also listed are additional violations for which citations and proposed penalties may be issued upon conviction.
These are the types of violations that may be cited and the penalties that may be proposed
April 17th, 2014
EFT Standardization Looks Promising
By | Published April 17th, 2014 - Last Review/Update January 25th, 2017
January 1, 2014 was the required date for adoption of standards for both Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). The Centers for Medicare & Medicaid Services (CMS) recently announced that the implementation of these new standards has resulted in benefits for both providers and CMS. Not surprisingly, ...
February 19th, 2014
Are Text Messages HIPAA Compliant?
By | Published February 19th, 2014 - Last Review/Update January 27th, 2017
As more and more people are using mobile and wireless devices, a new buzzword has emerged: mHealth. According to a National Institute of Health consensus group, mHealth is "the use of mobile and wireless devices to improve health outcomes, healthcare services and health research." Historically, the biggest gaps and HIPAA violations ...
February 12th, 2014
EHR Hardship Exemption
By | Published February 12th, 2014 - Last Review/Update January 27th, 2017
The following information is from the Centers for Medicare & Medicaid Services (CMS) regarding the Electronic Health Records (EHR) payment reduction hardship exemption.
January 28th, 2014
ICD-10 Guidelines that Chiropractic Physicians Should Remember
By | Published January 28th, 2014 - Last Review/Update January 27th, 2017
Depending on the publisher, there are about 30 pages of guidelines in the ICD-10-CM code set. The bulk of these guidelines, from section 1.C, are chapter-specific.
Chiropractic physicians typically use codes from just four or five of the 21 chapters available in ICD-10-CM. These include, but are not necessarily limited to, ...
September 30th, 2013
Are You Compliant with the New HIPAA Regulations?
By | Published September 30th, 2013 - Last Review/Update January 27th, 2017
September 23rd, 2013 was the deadline for HIPAA Omnibus Final Rule compliance. It seems to have just snuck up on everybody. ChiroCode has spoken with some clincis who say that they don't need to worry about it because ”they are just a small practice.” Please, do not wait any longer to ...
September 24th, 2013
Federal Health Care Fraud Summary 2012
By | Published September 24th, 2013 - Last Review/Update January 27th, 2017
Be aware of the possible monetary results and enforcement actions imposed for fraud. This is the annual report of the Department of Justice Health Care Fraud and Abuse Control Program for FY 2012
September 11th, 2013
ICD-10 Coding Possibilities for Chiropractic Physicians
By Evan M Wsilliam, DC, CPC, CCPC, NCICS, CCCPC, CPC-I, MCS-P, CPMA | Published September 11th, 2013 - Last Review/Update January 27th, 2017
Right now, it’s hard to say which ICD-10 codes third-party payers will select as medically necessary, but we can make an educated guess based on information from a few sources. More detail is expected from Medicare before the end of 2013. For doctors of chiropractic (DCs), the natural place to start is with the relatively short list of frequently used ICD-9-CM codes for submitting claims. We’ll investigate a handful of diagnosis codes that Medicare recognizes as medically necessary and explore ICD-10-CM code possibilities.
July 25th, 2013
Medicare Considering Paying DCs for E/M Services
By | Published July 25th, 2013 - Last Review/Update January 27th, 2017
A notice in the July 19, 2013 Federal Register, has a VERY important clause for all Doctors of Chiropractic! The Centers for Medicare and Medicaid Services (CMS) has asked for comment on whether or not Doctors of Chiropractic should be paid for Evaluation and Management (E/M) services. Keep in mind ...
July 8th, 2013
Denials for 97140 (Manual Therapy)? Here's the story.
By | Published July 8th, 2013 - Last Review/Update January 27th, 2017
The ChiroCode Institute has received several inquiries over the last few months regarding a denial for 97140 (Manual therapy—such as myofascial release or trigger point therapy) when billed with 98940-98942 (Chiropractic Manipulative Treatment - CMT) on the same visit. Most payers follow Medicare’s guidelines for the use of this code, ...
April 12th, 2013
Chiropractic Coding & Billing Training - Which Course Is Right For You?
By | Published April 12th, 2013 - Last Review/Update January 27th, 2017
Often times we get calls at ChiroCode from offices looking for training. Sometimes it is due to employee turnover and other times it is from a new office trying to get started. And everyone is looking for affordable help!
There are hundreds of seminars and clinics available for training if you ...
September 29th, 2012
Privacy Rule De-Identifiers
By | Published September 29th, 2012 - Last Review/Update January 27th, 2017
The HIPAA Privacy Rule provides two ways to de-identify information, which are listed here with the 18 de-identifiers.
August 30th, 2012
Inappropriate Medicare Payments for Chiropractic Services
By | Published August 30th, 2012 - Last Review/Update January 27th, 2017
OIG released two reports critical of the way chiropractic handled documentation and coding. Their findings are included in this article. Read further to see what documentation is needed for proper payment.
As required by the Social Security Act, Medicare pays only for reasonable and necessary chiropractic services, which are limited to active/corrective manual manipulations of the spine to correct subluxations. A chiropractic service must have a direct therapeutic relationship to the patient’s condition and provide reasonable expectation of recovery or improvement of function.
August 29th, 2009
Chiropractors Directory
By | Published August 29th, 2009 - Last Review/Update January 27th, 2017
December 31st, 2001
Commonly Asked Chiropractic Coding Questions
By ChiroCode | Published December 31st, 2001 - Last Review/Update August 19th, 2015
Commonly Asked Questions:
1. Retention of Records
2. 97140 Denials
3. Exercise Equipment
4. Coding for BioFreeze
5. 97014 or G0283
6. Billing for additional insurance forms
7. Report of Findings
8. Laser therapy
9. Spinal Decompression
10. Diagnosis Coding – 4th and 5th digit
11. Re-Reading X-rays
12. Outcomes Assessment Questionnaires
13. Accounts Receivable
14. 15-Minute Units
15. E/M and CMT
December 31st, 1969
National Association of Insurance Commissioners (NAIC) Directory
By | Published December 31st, 1969 - Last Review/Update August 10th, 2015
National Association of Insurance Commissioners (NAIC) Directory
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