Documentation continues to be the chiropractic profession's greatest weakness when it comes to receiving insurance reimbursements, mainly Medicare reimbursement. I can not express enough how important it is for a Chiropractor to improve documentation for services provided. For a service to be reimbursable through Medicare, the documentation must show clinical necessity for the patient's care. [...]
Question: I am getting denied for 97140 when I bill it with an adjustment. What can I do? Answer: When billing 97140 with an adjustment, you will first have to use the modifier -59 which indicates to the insurance company that this service (97140) was done on a separate region of the body other than [...]
Question: We would like to start billing for report of findings using the proper documentation. We would also like to go through the past year or so and bill for all of the previous reports as well. How legal is this and is there an expiration on how far back I can bill? Answer: “Report [...]
Question: Is there a code for laser light therapy? Answer: There is no accurate and current CPT code for "laser" treatment, providers should use the S8948 HCPCS code for "Application of a modality (requiring constant provider attendance) to one or more areas; low level laser; each 15 minutes." This is our first choice and recommendation. [...]
Question: What CPT or HCPC should be used when billing Spinal Decompression to insurances (like Aetna, Cigna and/or Medicare)? Answer: Many payers recognize/use 97012 - mechanical traction for Spinal Decompression. Other options within CPT would be to use the unlisted codes of 97039 or 97799 in the Physical Medicine Section. 97039 is an "unlisted modality" [...]
Information Regarding the Holding of Claims for Services Paid Under the 2010 Medicare Physician Fee Schedule To the extent possible and in consideration of possible legislative changes, the Centers for Medicare & Medicaid Services (CMS) is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care [...]