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2021 Chiropractic Cheat Sheet

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Additional Links and Resources

General Coverage and Subluxation

Noridian - Chiropractic General Coverage and Subluxation

Noridian: Chiropractic Resources

Noridian JE Part B Chiropractic Resources

Chiropractic Services Fact Sheet

This Fact Sheet is for informational purposes only and is not intended to guarantee payment for services...

Drugs and Biologicals Pub-100 Ch 17

Drugs and Biologicals Pub-100 Ch 17

Billing Requirements for OPPS

Billing Requirements for OPPS Providers with Multiple Service Locations

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ICD-10-CM 2021 Codes for your Specialty

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

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Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program

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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.

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ICD-10-CM 2021 Coding Updates for Chiropractic

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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.

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Watch for Payer Telehealth Coverage Changes

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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.

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Getting Your Practice Back on Track

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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.

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COVID-19 Chiropractic Resources

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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.

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More Telehealth Changes Announced by CMS Chiropractic Offices Should Know About

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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.

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CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes

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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 ...

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COVID-19: Cybercrime, Telehealth, and Coding

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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 ...

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Acupuncture Clarification

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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.

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Medicare Begins Covering Acupuncture Services

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Medicare is changing their policy regarding coverage of acupuncture, but in order to provide these services, you must follow their rules.

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Q/A: Did Noridian Stop Covering the M99.0- Codes?

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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?

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Billing for Telemedicine in Chiropractic

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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.

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Q/A: Can Chiropractors Bill 99211?

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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...

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Select the webinar title to view a summary and link to the webinar video.

Finally, the SOAP Note That Will Satisfy Everyone

Every regulator, every payer, and every chiropractor will tell you that they have the perfect SOAP note. But then why are they all different? In this raucous presentation Dr. Gwilliam, Clinical Director for PayDC EHR software, will finally bring all these parties together. We'll look at the requirements and elements that make up a good note and then break it down so that you can build one without suffering from a breakdown.

Watch the video on ChiroCode.com →

Proving Medical Necessity and Functional Improvement

Medicare is required by law to pay for care that is medically necessary. Medicare considers functional improvement to be the primary indicator of medical necessity for chiropractic care. It is up to you, the doctor, to prove functional improvement and medical necessity with your documentation. Dr. Short will show you how to use common practice tools to document functional improvement, medical necessity and maximum medical improvement.

Watch the video on ChiroCode.com →

Inappropriate Payments Made to Chiropractors – An OIG Review

In this webinar, Dr. Gwilliam will take you on a fun filled journey through all of the reports created by the Office of the Inspector General based on their reviews of chiropractors. If you can understand what they see, and what advice they give Medicare when dealing with chiropractors, then you will be better prepared to not become their next target. This webinar may feel a little frightening with hundreds of thousands of dollars paid back to CMS, but, by the end, you will know exactly what to do and what not to do.

Watch the video on ChiroCode.com →

Expanding Chiropractic Coverage in Medicare

Currently Medicare only pays for the adjustment and then only when it is used to correct a subluxation. This injustice within the Social Security Act needs corrected. Dr. Ron Short will discuss the Medicare laws as they relate to chiropractic and what changes need to be made and why. ...

Watch the video on ChiroCode.com →

Confusing Codes for Chiropractors - 97110 versus 97112 versus 97530

In this webinar, you'll get a deep dive into three therapeutic procedure codes. Dr. Gwilliam, a chiropractor and certified professional coder, will take you thorough the ins and outs of therapeutic exercises, activities, and neuromuscular reeducation. They will be compared and contrasted with examples to make sure everyone leaves with the confidence to document and bill them correctly.

Watch the video on ChiroCode.com →

Evaluation and Management Coding

The Evaluation and Management service is an important part of an episode of care. It is the initiation of care and determines the scope and severity of the patient’s condition. Dr. Ron Short will review the levels of Evaluation and Management codes and which are appropriate in the chiropractor’s office. In this webinar you will learn: What constitutes a new patient Which Evaluation and Management codes should not be used When to use the consultation code What changes are coming to Evaluation and Management coding

Watch the video on ChiroCode.com →

Chiropractic Manipulative Treatment and Medicare - Part 2

In this CE webinar, Dr. Gwilliam will continue his discussion from the webinar delivered Dec. 18 about chiropractic manipulative treatment. But this time, it is all about Medicare. If you don't treat Medicare beneficiaries, you should probably listen anyway. Usually whatever Medicare wants is the same thing as all the other payers. Find out the difference between acute, chronic, and maintenance, as well as when to use certain modifiers.

Watch the video on ChiroCode.com →

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2020 ChiroCode Deskbook2020 Chiropractic Diagnosis & Documentation Cards2020 Chiropractic ICD-10-CM Coding BookACA Coding Policy: Coding Misuse Prompts Fraud InvestigationsAdvanced Beneficiary Notice of Noncoverage (ABN) Form Instructions ToolAmerican College of Radiology Practice Parameter for Communication of Diagnostic Imaging FindingsBilateral Surgeries: Claim SubmissionCommonly Used Medicare Modifiers - GA, GX, GY, GZDetailed Information on the New Safety Data Sheets (SDS)Discount Plan or Health Insurance? by FTCDisposal of Protected Health InformationFair HealthHHS, Justice Department warn hospitals on EHR-related payment fraudHIPAA: Health Insurance Portability and Accountability Act by AMAMedicare Part B Clinical Laboratory Fee ScheduleMedicare Recovery Audit by HHS Office of the Inspector GeneralMedicare: To Participate or Not to Participate?Modifier 59 MLN Matters #MM8863Noridian Chiropractic PoliciesNoridian: Allowed Amount ReductionsOfficial HIPAA Guidelines for Media SanitationOIG Compliance Program for Individual and Small Group Physician Practices - Federal RegisterOSHA Small Business Resources - includes trainingOSHA's Computer Workstations eToolPhysician Assistant (PA) Resources NoridianSecurity Risk Analysis Tip Sheet: Protect Patient Health Information by CMSSonomaSummary of the HIPAA Privacy Rule by HHSSummary of the HIPAA Security Rule by HHSTemporary Worker Injury and Illness Recordkeeping Requirements by OSHATop 10 Chiropractic Fee Questions: How Much Can I Charge?United States Department of Labor; Occupational Safety and Health AdministrationVeteran's Patient-Centered Community Care Program Chiropractic Reference Card


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Do You Have All the Right Dental Resources Needed to Succeed in Dental Medical Billing and Coding?

Discussion with LaMont Leavitt (CEO of innoviHealth) and Christine Taxin (Adjunct professor at New York University, President of Dental Medical Billing, and Links2Success). Some of the resources and tools they discuss will help you with your dental coding/billing and education.

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For additional information visit ChiroCode.com. Since 1993 Chiropractors have depended on ChiroCode as a reliable source of information for the Chiropractic community. View current and recent webinars, order the ChiroCode DeskBook, (comprehensive go-to chiropractic reimbursement manual) and much more. Because of the dependability and education, ChiroCode has earned much renown.



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