Chiropractic Coding & Billing Articles

Knowing when to report symptom codes has always been a conundrum for coders at one point or another in their career but with the complex EHRs and coding systems used today, requiring a ...

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 ...

It’s that time of year again, the ICD-10-CM codes for fiscal year 2024 are out so it’s time to take a look at these changes. Of all the hundreds of changes, the following could be o ...

One of the more common forms of tenosynovitis is when the sheath that covers the two tendons connecting the forearm muscles to the bones of the thumb and wrist becomes inflamed from ove ...

The second quarter of 2023 is NOT business as usual so it is important to pay attention to ensure that organizational processes and training take place to avoid mistakes. Not only have ...

There were several changes to the ICD-10-CM codeset for 2023 which went into effect October 1, 2023 and could impact chiropractic. At the time of publication, it was unknown how payers ...

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 ...

Excludes1 edits can cause problems with claim denials. It is important to watch for annual changes to the Excludes1 and Excludes2 edits. Know the rules to properly submit and appeal cla ...

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 ...

Properly documenting and coding chronic pain can be challenging. As is commonly the case with many conditions, over the years, there has been a shift in the identification of different ...

Question: Recently my claims to Medicare are being denied when I submit a secondary diagnosis code. I’ve heard that this is happening in several states including Washington, Californi ...

October 1st is just around the corner and that means it’s time for updates to the ICD-10-CM code set. This year there are some interesting changes such as a new headache type, new cod ...

The ICD-10-CM Official Coding and Reporting Guidelines have just been updated to include COVID reporting. Additional information beyond the previously released interim guidelines are in ...

Question: I heard that Medicare Noridian Jurisdiction F (Alaska) has been denying claims with M99.00, M99.01, M99.02, M99.03 etc codes when billed with the CMT CPT codes. Did Medicare ...

There are some interesting coding changes which chiropractic offices will want to know about. Are codes that you are billing changing? ...

Question:  It is in regards to the Initial and Subsequent 7th digit (A and D) for sprains and strains. Recently, I have been told that I should continue with the A digit until the pat ...

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 ...

Question: I got a denial on my claim and it said the problem was with the diagnoses codes that I used. I used M54.15 and M79.2. I don’t understand why this is a problem. ...

Question: My patient has a lot of chronic conditions. Do I need to include all these on the claim? I know that I can have up to 12 diagnoses codes on a single claim. What if I need more ...

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 va ...

Code 95992 has some very limited payer payment guidelines which need to be understood for proper reimbursement. Many payer policies consider this service bundled with Evaluation and Ma ...

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 cod ...

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 clearin ...

Question: I have a provider that provides Department of Transportation (DOT) exams. I have found ICD-10 code Z02.4 (encounter for examination for drivers license) but I am unsure which ...

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? ...

What is new for Chiropractors for 2018? See for yourself the new ICD-10 and CPT Codes. ...

What is the ICD-10 code for acetabular labral tear? ...

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 ...

What are the best diagnosis codes for E-stim? ...

There are thousands of code changes going into effect on October 1. Here is a list of the the 70 or so that are most relevant to chiropractors. ...

ICD-10-CM changes for 2017 include 1,974 new codes, 311 deleted codes, and 425 revised codes. Chiropractors, fortunately, are only affected by about 70 of these changes. And none of the ...

The Centers for Medicare & Medicaid Services (CMS) recently released the Proposed Rule regarding the updates to the ICD-10-CM and ICD-10-PCS code sets for Fiscal Year 2017 which begins ...

The official guidelines for ICD-10-CM define the conventions used in the code set. In section 1.A.6, we learn the following about some common abbreviations in the Tabular List: ...

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 ...

In some places, the ICD-10-CM code set uses words we think we are familiar with. However, a review of the guidelines shows that some of these words have very specific definitions. Her ...

In some places, the ICD-10-CM code set uses words we think we are familiar with. However, a review of the guidelines shows that some of these words have very specific definitions. Her ...

Q: We cannot find codes to identify the left or right side of the spine, such as with low back pain.  Do we add digits 1 or 2 to the code to clarify left or right? A: No.  C ...

Don’t code radiculitis (M54.1-) separately if you use the fourth character of “1”, “with radiculopathy”, for the disc disorders (M50.1- or M51.1-). It is already included in t ...

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 ...

Your 2016 ICD-10-CM Coding for Chiropractic is a lot more useful than you might know. Most are familiar with the Anatomic Diagnosis Code List - always a ChiroCode favorite. Well, ...

Ever wondered how to code for wellness visits. Even though they are typically not billed to third parties, there is a right way to record these kinds of encounters. ...

Who is in charge of these updates? March 9-10, 2016 the ICD-9-CM Coordination and Maintenance Committee met to discuss changes to ICD-10-CM, which begin October 1, 2016 at the earliest ...

ICD-10-CM will be unfrozen October 1, 2016. Will the updates make a big difference? Or are they minor? Find out in this short article. ...

Coding for a reduced cervical curve is a little tricky in ICD-10. This article explores the choices and issues around this diagnosis. ...

How do you code for a bilateral condition, such as sciatica? ...

Question: How do we know which codes a payer will allow? ...

Sample Chiropractic SOAP note ...

Chapter 20 External Causes of Morbidity includes codes from V00 to Y99. They were greatly expanded in ICD-10-CM. ...

The sprain and strain codes offer three choices for the final character: A - initial encounter D - subsequent encounter S - sequela ...