General Surgery Coding Alert - 2013 Issue 39
Chiropractic Services: Could Chiropractors Start Collecting for E/M Services?
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Article Overview
This article explains proposed and current Medicare guidance relevant to chiropractic services. It focuses on the possibility of future evaluation and management billing for chiropractors, while also summarizing existing requirements for chiropractic manipulative treatment claims, supporting diagnosis documentation, and related Medicare policy references. The piece is aimed at chiropractors, billing staff, and coders who need to understand how CMS and Medicare contractors are framing these services.
Why This Topic Matters
It helps readers track a potential policy change while reinforcing the documentation and coding requirements that affect current claim submission and medical necessity support for chiropractic services.
Article Sections
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CMS proposal and chiropractic E/M services
Introduces the Medicare fee schedule discussion about whether chiropractors may be considered for billing evaluation and management services in the future. Also places the topic in the context of broader payment changes affecting other specialties.
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Continue With CMT Billing
Reviews the current chiropractic service framework under Medicare and the need to follow existing billing and documentation guidance. The section centers on ongoing claims processing considerations for chiropractic manipulative treatment.
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Ensure Subluxation Is in the Notes
Summarizes the documentation and diagnosis-support expectations discussed by Medicare contractors for chiropractic claims. It also references diagnostic sequencing and the role of supporting clinical records.
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X-ray documentation and CMS transmittal guidance
Explains the change in Medicare policy regarding x-ray documentation and the continued emphasis on clinical record detail. The section notes a CMS transmittal and the type of information expected in the patient record.
What You Will Learn
- How CMS is discussing chiropractic participation in broader Medicare service categories
- What current Medicare guidance says about chiropractic billing and documentation
- How Medicare contractor guidance addresses diagnosis support for chiropractic claims
- How changes in recordkeeping expectations affect substantiation of chiropractic services
Who Should Read This
- Chiropractors
- Chiropractic billing staff
- Medical coders
- Practice managers
- Medicare billing specialists
Codes Discussed
Code Ranges Discussed
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