Chiropractic Coding & Billing Articles

One of my favorite things to do is help clients extricate themselves from a False Claims Act investigation. I like it because it’s intellectually challenging, and few things are more ...

UnitedHealthcare has issued a notice that there is a new Manipulation Commercial Payer policy which will become effective on July 1, 2023. Learn about the changes to the “Coverage Rat ...

When x-rays are audited on the same date as an E/M encounter we have one of three decisions to make about the work that went into the radiological exam when the practice owns x-ray equi ...

Every healthcare office needs to know and understand the rules that apply to billing services and supplies. What lessons can we learn from the mistakes of others? What if we have made t ...

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 cla ...

Any type of payer review can create some headaches for providers and cause problems for a healthcare office. Even for a practice that has taken administrative steps to try and prevent a ...

Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the sam ...

As both a chiropractor for 31 years and one who reviews a lot of medical records for the medicolegal arena and has been teaching documentation for many years, the range of motion ques ...

Question: Our claims are being rejected. We think it is related to our diagnosis codes. What is the reason for this? ...

Generating a differential diagnosis — that is, developing a list of the possible conditions that might produce a patient's symptoms and signs — is an important part of clinical reas ...

Effective March 14, 2016, the CMS Final Rule clarifying the standards for handling overpayments for both Medicare and Medicaid takes effect. Failure to report and subsequently return ...

When a claim has been determined to be paid more than the allowed amount, it is considered an overpayment. The action to be taken depends on how the overpayment is discovered. This arti ...

Q&A: If we use low level codes on each visit (such as 98940, 99212, 99202), will our chances of being audited be less than if we billed higher level codes? ...

Q: Do you have any recommendations for audit prevention? ...

Here at ChiroCode we often get to look at doctor records and provide advice on ways to improve them. One of the main issues is lack of functional progress to establish medical necessit ...

One of the hardest parts when reviewing a medical record for coding or auditing is the determination of what conditions were addressed. Any condition that is taking into account or affe ...

Occasionally providers are faced with the need to assess the option of making a voluntary disclosure to the government. Here are steps that every provider should consider before disclo ...

Many healthcare organizations are not aware of how critically important it is to screen their employees against ALL state and federal exclusions databases. This article has important i ...

CMS is developing a new Unified Program Integrity Contractor (UPIC) program to consolidate Medicare and Medicaid reviews. This consolidation of the Medicaid Integrity Contractors (MICs ...

Four Tactics or tips to help you fight back when you are audited or have your claims reviewed. They are effective and easy to use. ...

How secure is your computer? Do you have a password on your computer? Do you have the automatic log offs turned on? Is your computer encrypted? Are your off-site storage files encrypted ...

Audits are on the rise and the last you want to do is get tangled up in a fight over money you have already been paid. A smart chiropractor will audit himself to make sure there is litt ...

Compliance specialists are responsible for monitoring health and human services program operations for compliance with federal and state regulations and standards in order to promote he ...