The Congress Of Chiropractic State Associations (COCSA) has voted to join a national ERISA class action filed by Pomerantz Haudek Grossman & Gross LLP, one of the nation's preeminent class action law firms, against UnitedHealth Group. In the action, COCSA will be representing its members, State Chiropractic associations in all 50 states, in combating alleged ERISA violations in overpayment recoupment abuses.
Question: How do we correctly bill for 97035 Ultrasound (two) units? I realize ultrasound is a timed therapy and two units represent twice the time. But can it also show one unit for the cervical spine and one unit for the lumbar spine, and how is it shown on the 1500 form?
Question: Is the maintenance code S8990 still in use? We have several patients who claim that they have "wellness" visits under their insurance plan. Should we bill their health insurance with this wellness code, and then transfer the balance to the patient if the insurance doesn't pay?
On October 27, 2010, a Federal Court Ruled against Blue Cross and Blue Shield of Rhode Island's (BCBSRI) overpayment recoupment practice. The Court relied upon a U.S. Supreme Court Ruling in Aetna v. Davila, and ruled that federal ERISA law limits the potential recovery by BCBSRI, and that BCBSRI's state law claims for breach of contract and fraud are completely preempted by the Employee Retirement Income Security Act (ERISA). BCBSRI's post-payment audit is a fiduciary conduct governed by Federal Law ERISA instead of provider PPO contract.
Question: We are having code 96002 for computerized EMG procedure denied as "per the CPT guidelines, this service is not appropriate in this setting (place of service)." We submitted codes 98941 and 96002-25.
In this four part webinar series, Dr. Ron Short will tell you about the three major problems that Medicare has with chiropractic. Chiropractic is currently under Special Study Review by Medicare. The review will continue until the national average error rate for chiropractic falls below the overall national average. It is up to us as individual doctors to have correct protocols and procedures in our offices. Dr. Short will tell you how to accomplish that goal.
Save time with simple, fast code searching. Eliminate coding frustrations by getting the timely answers you need. Avoid denials and lost payments with current, up-to-date information. Improve your office's bottom line. Enhance your skills as a coder.