Personal Injury Topics Page

Each October 1st, the newest updates to ICD-10-CM take effect. This year with more than a thousand new codes added there is a lot of information to dig into and prepare our providers for. Many of the deleted and changed code descriptions, including the endeavor to capture social determinants of health, were made to enable expansion of specific coding categories so additional details could be reported, when captured in the documentation.

After events of mass violence, it’s easy to feel helpless, like there is little we can do. In fact, we can help individuals, families, and communities build resilience and connect with others to cope together. The SAMHSA-funded National Child Traumatic Stress Network has developed a range of resources to help children, families, educators, and communities including the following which you can access via links in this article.

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 ...

Question: Do the Croft Guidelines apply to a patient's condition immediately following the collision or are they applicable to a patient's state when they first come to see you? Whether that has been weeks or months since the collision without treatment?

Question:  In Pennsylvania for Personal Injury cases we do not need to go through specific care paths or get precertification in order to treat patients, however, in New Jersey (NJ), doctors that practice there are required to get that precertification. Our question is that when we bill a New Jersey auto ...

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....

Question: I have a patient that was involved in a PI case. His lawyers are asking that we bill his insurance company first. This particular patient has xxxx insurance and the clearing house is rejecting the claim based on "ERROR 3430-Invalid principal diagnosis code." We lead with diagnosis code V43.52XA, could we change the position of the V43.52XA code? Or should we submit a paper claim for the case instead?

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.

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.

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.