839 Versus 739 Diagnosis Codes
Question: I have recently received a memorandum from my carrier stating that I should now use the 739 series ICD-9 codes as opposed to the 839 series. Is this a new CMS policy, and if so, will it have any affect on reimbursement of CMT procedures?
Answer: There is no new CMS policy on this issue; rather, it is a carrier specific requirement. The majority of carriers prefer the 739 ICD-9 series, which describes lesions, as opposed to the 839 ICD-9 series, which describes dislocations. A carrier requiring this as part of its Local Medical Review Policy (LMRP) does nothing in the way of altering reimbursement amounts, and does not in any way affect other guidelines associated with reimbursement of CMT procedures under Medicare.
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Isn’t this in effect allowing the ins. co to reduce the significance of a “subluxation” to just a “lesion” causing the term Subluxation (even though the medical subluxation is not a chiropractic subluxation) to be used less and less, similar to what we allowed to happen with the chiropractic “adjustment” ito become in ins terms a “manipulation”?
I would suggest you inform the ins co that you are the doctor, doctor, and you are caring for a subluxation and not a lesion. Who is caring for this pt. you might also ask.
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Looking for a diagnositic code for: Misaligned displacement vertebrae of the spine
The most common codes for Spondylolisthesis are 738.41 (Acquired spondylolisthesis) and 756.12 (Spondylolisthesis). Hope this helps.
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Jacque