Yes, I know we are close to the One Year Anniversary of ICD10, but......there's still some lingering questions. One of them....which codes do I use to diagnose subluxations? Is it the M991 series or the M990 series? A recent OIG report about chiropractic says: "Medicare requires that chiropractic claims have a primary diagnosis of “subluxation” [...]
2016 X-Ray CPT Code Changes
If you take x-rays in your office, there are a number of additions as well as a few deletions to the CPT code set that will affect chiropractors in 2016. Let's take a look at these changes: CPT codes 72010 (full spine X-ray), 72069 (thoracolumbar standing scoliosis study) and 72090 (scoliosis study) have been deleted as [...]
Medicare Holding 2016 Claims
On October 30, 2015, the CY 2016 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors will hold claims containing 2016 services paid under the MPFS for up to [...]
Aetna Denies 97140
As if it wasn't difficult enough to receive proper reimbursement from some carriers, Aetna is throwing in another wrench in the process. They are now ROUTINELY bundling and denying reimbursement for manual therapy (97140) when billed with a CMT code (98940-43). According to Aetna, “there are very few indications for the application of manual therapy [...]
2013 Chiropractic CPT Changes and Updates
As we anticipate a vast number of changes due in 2014 with the implementation of ICD10, we will not see many changes this year. Listed below are the changes in CPT coding that will affect Chiropractic billing. Therapy / Rehabilitation Codes 97530 = Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve [...]
2013 Medicare Fee Cuts
Well, it's December 28, 2012 and still no final word about whether or not we'll experience a cut in pay from Medicare. If the White House and Congress does not come to an agreement soon, Chiropractors (and other physicians) will face a 26.5% reduction in reimbursement. Now there's not much we can do about that; [...]