Chiropractic Coding & Billing Articles

Coders often find themselves unsure of when to report a sign or symptom code documented in the medical record. Some coders find their organization has an EHR that requires a working dia ...

The standardization of medical records offers numerous benefits for healthcare systems, providers, and patients. By ensuring interoperability, improved workflows, better patient safety, ...

Healthcare is witnessing a digital revolution of sorts with advancements in technology that seem to transform many aspects of patient care. An example of this transformation involves th ...

Coders often see conditions that seem to always be reported together. Diabetic patients tend to develop other conditions as the diabetes continues to progress instead of improving. Comb ...

Chiropractors treat, among other things, issues with the musculoskeletal system. Active therapeutic procedures are accepted as effective ways to treat many common conditions and theref ...

How did you do? Take a look at the Improper Payments Report and see where there can be improvement in your practice. ...

The Medicare Improper Payment Report does not measure fraud, but rather, it estimates the payments that did not meet Medicare coverage, coding, and billing rules. The estimated Medicare ...

New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective o ...

CMS audits claims on an annual basis to identify improper payments. These improper payments do not measure fraud. Rather, they estimate the share of payments that did not meet Medicare ...

Question: What type of documentation is required for a Medicare patient with degenerative joint disease who get adjusted once or twice a month for occasional flare-ups of the D. J. D. ...

The Medicare Improper Payment Report for 2018 is not a measurement of fraud. Rather, it is an estimate of the claims paid by Medicare which did not meet Medicare coverage, coding, and b ...

Have you ever tried to quickly recall the elements required to support a comprehensive ophthalmologic exam versus an intermediate one? Make coding decisions quickly by creating a cheat ...

Is "noncontributory" really an unacceptable word to describe a patient whose family history doesn't have any bearing on the condition being evaluated and treated today? ...

Question: If orthopedic tests are negative, do you need to still list them in your treatment notes? Answer: Yes. Any tests which are performed by a healthcare provider, regardless of t ...

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 ...

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 ...

Medicare's guidelines for reporting of timed codes is found in Medicare Claims Processing Manual Chapter 5, Section 20.2. Also known as the '8 minute' rule, it describes how to calcula ...

In August of 2017, a Brooklyn chiropractor was ordered to repay $672,805 to Medicare because the reviewer found that 100% of the claims reviewed (from 2011-2012) did not meet medical ne ...

In order to understand and answer the question, "Why code 99080 is being denied when billed with an E/M Service, it is important to first review the requriements of selecting the approp ...

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 ...

There has been some controversy over the use of the ICD-10-CM subluxation codes commonly referred to as traumatic (S13.1-, S23.1-, and S33.1-). Are they appropriate for chiropractors to ...

Q: In order to code carpal tunnel syndrome G56.01 or G56.02, does there need to be documentation that nerve conduction (EMG testing) has been performed to confirm the diagnosis? ...

Here at ChiroCode we are often asked for examples of perfect forms to use in the office. As such we have developed some. ...

Does every single visit need to document quality and quantity of pain and an update to the treatment plan? ...

What is the proper usage of CPT 97150 and what are the documentation requirements for that? ...

General Rules/Facts Related to the Proper Use versus Misuse of Guidelines ...

The Medicare Improper Payment Report for 2016 has been released by the OIG. Please note that the improper payment rate does not measure fraud. Rather, it estimates the payments that did ...

Documentation Solutions, a quick tip video by Dr Gwilliam. ...

Is there a way to bill out for Class 4 deep tissue hot laser treatments? ...

What is required for documenting a maintenance visit for a Medicare beneficiary? Watch this video by Dr. Evan Gwilliam for his thoughts. ChiroCodeQ&A_maintenance visit from Innoven ...

Patient-reported outcome measures are increasingly necessary elements of good clinical practice.  By using a clinically meaningful outcome measure at the initial assessment and measuri ...

Q: An insurer told me that chiropractors cannot bill 99204 or 99214 because those exams "require a level of decision making that would typically only occur in an emergency room." Is thi ...

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 ...

Whiplash Damages in Rear-end Collisions - The Patient’s Dilemma: The rear-end collision is a major cause of cervical spine injuries which often require treatment by chiropractors an ...

Are you having a difficult time getting reimbursed? Are claims being denied because the insurance classifies everything as maintenance? ...

Physician referrals -- When can we bill a consult code? If we do not have the referral on our referral pad can we bill the consult code? ...

(from page 210 in chapter 3.5 of the 2017 DeskBook) One of the biggest problems providers face when audited is that many services are deemed not medically necessary and are routinely de ...

A chiropractor recently contacted ChiroCode and told us that a payer claims that 97140 manual therapy and 97112 neuromuscular re-education are not separately billable from a chiroprac ...

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 ...

The following is a letter from CCGPP's Chairman, Dr. Greg Baker.  Dr. Gwilliam, ChiroCode's Vice President, is a board member and whole-heartedly supports this cause, which is, in pa ...

Palmetto GBA (Railroad Medicare) recently released the results of their “Widespread Review of Chiropractic Services for the first quarter of FY 2016” and while the overall charge de ...

The Office of Inspector General's (OIG) mission is to protect the integrity of Department of Health & Human Services (HHS) programs as well as the health and welfare of program benefici ...

Documentation provides clear evidence of continuity of care to communicate with other providers.  It can act as a legal record of the care given.  And it should support the billing fo ...

Sample Chiropractic SOAP note ...

Commonly Asked Questions: 1. Retention of Records 2. 97140 Denials 3. Exercise Equipment 4. Coding for BioFreeze 5. 97014 or G0283 6. Billing for additional insurance forms 7. Report of ...

Patient Portion The first part of the form is for the patient to complete. The date, name and age are completed, along with a brief description of why they came in for a visit. Pain “ ...

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 ...

Muscle and Range of Motion Testing guidelines have recently been clarified in the AMA CPT Assistant. Muslce Testing Table included ...