Billing: CMS Evaluating Chiropractors' Ability to Provide And Collect for E/M Services

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a Medicare payment and billing update affecting chiropractors and summarizes the current CMS framework while a proposal is under review. It is intended for chiropractors, billing staff, and medical coders who need to understand how the discussion relates to Medicare coverage, documentation, and diagnosis reporting for chiropractic services. The article also references agency guidance and carrier policy sources that shape how claims are supported under existing rules.

Why This Topic Matters

It helps readers determine whether the article is relevant to chiropractic Medicare billing and to understand the general policy context surrounding possible future E/M payment changes and current documentation requirements.

Article Sections

  1. CMS proposed 2014 Medicare Physician Fee Schedule

    Discusses the payment environment described in the proposed fee schedule and the broader context for chiropractic reimbursement in Medicare.

  2. Continue With CMT Billing

    Summarizes current billing expectations for chiropractic services under existing Medicare guidance and related documentation concerns.

  3. Ensure Subluxation Is in the Notes

    Covers diagnosis support and documentation topics related to medical necessity, claim reporting, and recordkeeping requirements.

What You Will Learn

  • How a CMS proposal may affect chiropractic Medicare billing in future rulemaking
  • What the article says about current billing focus for chiropractic services
  • Which general documentation and diagnosis-support topics are emphasized for claim substantiation
  • How CMS and Medicare carrier guidance are presented as affecting chiropractic claim review

Who Should Read This

  • Chiropractors
  • Medical coders
  • Billing and reimbursement staff
  • Practice administrators
  • Medicare claims professionals

Codes Discussed

  • CPT: 98943
  • ICD-9-CM: 739.3
  • ICD-9-CM: 722.52
  • ICD-9-CM: 739.4

Code Ranges Discussed

  • CPT: 98940-98942
  • ICD-9-CM: 739.x

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