Chiropractic Procedure Coding Articles and Resources

For professional services/procedures billed to third party payers, which are reported on the 1500 Claim Form, there are two recognized procedural coding sets that may be used for HIPAA transactions: the American Medical Associations’ Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS).

Continue reading more in chapter 6 of the ChiroCode Deskbook.

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ChiroCodes Free Blogs and Articles

Research coding articles and blogs by topics such as CPT Coding, ICD-10 Coding, Documentation, and more...

ChiroCode Deskbook

Comprehensive go-to chiropractic reimbursement manual featuring chapters on Procedure Codes (CPT) and Supply Codes (HCPCS).

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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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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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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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Will the New Low Level Laser Therapy Code Solve Your Billing Issues?

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Low level laser therapy (LLLT), also known as cold laser therapy, is a form of phototherapy which uses a device that produces laser beam wavelengths, typically between 600 and 1000 nm and watts from 5–500 milliwatts (mW). It is often used to treat the following: Inflammatory conditions (e.g., Rheumatoid Arthritis, Carpal ...

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Your New Patient Exam Code Could Determine How Many Visits You Get

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The initial exam is where the provider gathers the information to determine the need for all the care that follows. It is billed most often as an office or outpatient evaluation and management (E/M) code from the 4th edition of the AMA’s Current Procedural Terminology book. There are actually five ...

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Electrical Stimulation and Electromagnetic Therapy Devices

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Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint.

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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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Auditing Chiropractic Services

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Chiropractic is unique from other types of health care and auditors need to be aware of the nuances of this field. Chiropractic has become the focus of more and more audits as doctors seem to struggle to create records that properly support the care provided to the patient throughout the entire episode.

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Q/A: I Submitted a Claim to the VA and it’s Being Denied. Why?

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I submitted a claim to the VA and it’s being denied. Why? There are several reasons why your claim might be denied by the Veterans Administration (VA). However, without more information about the claim itself (e.g., services billed), we can only provide the following general information about the VA and chiropractic ...

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Corrections and Updates

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One constant in our industry is change. Policies change, contracts change, and there are updates. Also, people aren’t perfect and mistakes can be made. So this article will cover a variety of topics. Published Articles We appreciate feedback from our valued customers. We have received feedback regarding two of our articles which ...

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Physical Therapy Caps Q/A

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Question: How do I code it so that PT services in a chiropractic office don’t count against their PT visit max? Is there a way to code claims so that they are considered chiropractic only? But still get compensated enough? We have been running into some issues as of late ...

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AMA Issues new CMT Information

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As many of you may already be keenly aware, there have been ongoing problems with many payers (e.g., BCBS of Ohio) regarding the appropriateness of reporting an E/M visit on the same day as CMT (CLICK HERE to read article). The AMA recently released an FAQ which renders their opinion ...

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Dry Needling

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The correct coding of dry needling, also known as trigger point needling, has been a subject of confusion for quite some time. The American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA) have been working together for several years to obtain appropriate codes to describe this service. In ...

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2019 Coding Changes for Chiropractic

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The new year is upon us and so it’s time to double check and make sure we are ready. Those with Premium Membership can use the ChiroCode Online Library and search all the official code sets: ICD-10-CM, CPT, and HCPCS. It also includes the updated NCCI edits and RVUs for ...

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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.

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Billing Other Services with CMT

Presented by Evan Gwilliam DC MBA BS CPC NCICS CCPC CCCPC CPC-I MCS-P CPMA June 19, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET Are you getting denials from payers for things that they say are bundled into chiropractic manipulative treatment (CMT) codes? ...

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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.

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Which is the Most Profitable E/M Code for PI: 99203 or 99204?

There is a lot of myth surrounding the use of the E/M codes. Dr. Grant will discuss how to best use these codes in a PI case to avoid the potential for a fraud claim by an insurer or a malpractice action by your patient.

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How to Check NCCI Edits Using FindACode

How to Check NCCI Edits Using FindACode

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