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Chiropractic Compliance Articles and Resources

Because compliance covers so many areas of a healthcare provider practice, a more thorough explanation is found in Chapter 3-Compliance in the ChiroCode DeskBook. Generally, healthcare providers need to understand:

  • How to maintain a dynamic compliance plan
  • Fraud and abuse standards
  • Federal requirements (see related topics below)
  • How to minimize the impact of audits.

Related topics:

 


 

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

Chiropractic Compliance Articles and Resources Articles

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Q/A: I’m Being Audited? Is There a Documentation Template I can use?

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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 ...

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No Good Deed Goes Unpunished

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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.

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Q/A: Does My LMT need an NPI? How do I Bill Her Services?

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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, ...

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Q/A: Can a PT Assistant Perform Physical Therapy Modalities?

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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.

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Q/A: Should I be Using Modifier 96 on PT Claims?

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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?

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Patient Relationship Codes

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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 ...

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Chiropractic Compliance Articles and Resources Webinars

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March 5th, 2019: 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

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E/M and the Organ Systems Part 2 of 2

E/M and the Organ Systems Part 2 of 2

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E-M and the Organ Systems (Part 1)

E-M and the Organ Systems (Part 1)

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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 →

Chiropractic Manipulative Treatment (CMT) Coding and Documentation (Part 1)

The most used codes in chiropractic are 98940, 98941, 98942, and 98943. In this webinar, Dr. Gwilliam will go over the fundamentals of these codes and make sure you are proficient with them. They probably play a bigger part of your practice than any other code, so it is worth it to make sure you are reporting them correctly. By the end of this presentation you will be able to diagnose, document, and code properly for CMT, as well as avoid common mistakes.

Watch the video on ChiroCode.com →

The #1 most overlooked injury in PI, and it is found in over 90% of all cases

Presented by Tom Grant Jr. DC  December 11, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET *How to recognize this injury *The most effective documentation terms to use *The best combination of ICD-10 codes to validate it Register here: https://attendee.gotowebinar.com/register/8562161323381676035 ...

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Documenting Treatment Plan and Goals That Actually WORK - November 20th, 2018

Dr. Friedman will discuss the need to document Treatment Plan and Goals and what we MUST document and what we SHOULD document. He'll also demonstrate how we can do this in the least amount of time and with the least amount of effort.

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Chiropractic Practice For Sale - When, Where, Why & How Much?

Dr. Tom Necela of The Strategic Chiropractor will share tips & tactics to help you with some of the biggest decisions every doc faces towards the end of their career: when to sell, where to find buyers, why sell (and what other options are available) and of course, how much is your chiropractic practice worth. If you are considering a chiropractic practice sale or transition within the next few years, this is a webinar you won't want to miss!

Watch the video on ChiroCode.com →

How to Create a Medicare Compliance Plan

In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to create an OIG/Medicare compliance plan. He will explain how to create policies, how to perform a "self-test" on your SOAP notes, search the Medicare exclusions list, Stark, anti-kickback and how to handle compliance concerns.

Watch the video on ChiroCode.com →

Joints: Rotator Cuff, Elbow, Wrist, and Hand

In this webinar, Brandon will review the bones and major joints of the upper extremities (arm, forearm, wrist, hand, and digits), as well as their supporting structures and how they are affected by injury, disease, and other conditions.

Watch the video on ChiroCode.com →

Healthcare Compliance- Fraud/Waste/Abuse…Avoiding the Pitfalls

Presented by Howard Levinson, DC  June 12, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET Dr. Levinson will discuss what constitutes healthcare fraud, waste and abuse and some of the strategies the insurance industry uses to identify outlier providers. Examples of healthcare providers who ...

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The Most Expensive Documentation Mistakes Chiropractors Make

Notes need to give payers the information they need in order to adjudicate your claims. Do your notes include what they need to see? Can you standardize and simplify your note taking process to decrease your administrative burden? In this webinar, Dr. Gwilliam, Certified Coder, Certified Professional Medical Auditor, and Clinical Director for PayDC Chiropractic EHR Software, will show you how to make it easy. He will review examples and boost your confidence that you are doing things correctly.

Watch the video on ChiroCode.com →

Coding and Documenting Physical Therapy Treatment Modalities

Presented by Evan Gwilliam DC MBA BS CPC NCICS CCPC CCCPC CPC-I MCS-P CPMA May 22nd, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET Ever wonder how to get paid for that e-stim or ultrasound? Do payers give you a hard time and ...

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Strategy to Assess & Strengthen Cervical Posture

Join the posture expert, Dr. Steven Weiniger, to learn how observing posture engages people for StrongPosture® habits… such as getting adjusted! Posture literally sets the baseline for all locomotor function, and current research confirms the importance of improving vertical alignment to functionally improve pain as well as longevity. DCs across the globe use the free PostureZone app and StrongPosture® rehab protocols to literally help people stand taller. Learn the framework to communicate bio-mechanics to patients, the public and other professionals. First for patient compliance, then results, and then for retention and referrals!

Watch the video on ChiroCode.com →

What Every Spine Care Expert Needs to Know NOW- The X Factor

How Spine Care Experts Utilize & Get Paid for X-rays. How to select what x-ray views to bill for in certain diagnostic cases. New rules for x-ray reimbursement for 2018. HIPAA requirements for digital x-ray back up, EHR integration, and transmission. What findings are needed to justify medical necessity for spine x-rays? How to maximize your x-ray imaging department productivity. Discover the ROI of digital over plain film and in-house vs referring out. Biomechanical line drawings and measurements in your ROF - the key to better patient compliance.

Watch the video on ChiroCode.com →

How to Add Acupuncture to a Chiropractic Office

In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to add Acupuncture services to a Chiropractic office. Topics include how to find and employ acupuncturists, CPT/ICD-10 coding, 15 minute increments vs the 8 minute rule, how to bill for office visits on same day as acupuncture and how to create an acupuncture billing and coding policy manual.

Watch the video on ChiroCode.com →

Proper Coding and Billing for Drugs, Biologicals and Injections

Proper Coding and Billing for Drugs, Biologicals and Injections

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Chiropractic Compliance Articles and Resources Resources/Links



Chiropractic Resources

  • Deskbook (Reimbursement Guide)
  • ICD-10-CM Specialty Specific Code Book
  • Provider Documentation Guides
  • ICD-10-CM Comprehensive Code Books
  • Cheat Sheets and Diagnostic Coding Cards
  • and more...

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