Quick Questions
Chiropractic Consulting - Quick Questions by ChiroCode

Chiropractic Quick Questions - Current and Past

ChiroCode receives and answers hundreds of Quick Questions each month from our customers.  Customers who purchase the ChiroCode Membership are able to email questions directly to the experts at ChiroCode.  Professionals who have chosen the ChiroCode Premium Membership may also contact our Quick Questions hot line for instant answers.

ChiroCode accumulates the questions and answers and adds them to the ChiroCode KnowledgeBase which is available to Premium Memberss.  Also ChiroCode features a new Quick Question and Answer each week that appears on our home page along with the two prior questions.  These questions and answers are also shown below.  This page also contains the question portion from prior week's Quick Questions.  A full archive of all the ChiroCode Quick Questions and Answers can be found in the ChiroCode KnowledgeBase.

Premium Membership Sample:  Top 10 Frequently Asked Quick Questions - Answered by ChiroCode

Current Quick Questions

After-hours office visits

Question: 

Is there a code to bill to insurance for after-hours office visits?

Answer: 

There is a series of codes to indicate services requested after hours. Each of these codes would be reported in addition to the basic service. For example, if a CMT or E/M code was billed for an after-hours visit, you report that code in addition to the after-hours code. These codes are:

  • 99050: Services requested after office hours, but only up to 10:00 p.m.
  • 99052: Services requested between 10:00 p.m. and 8:00 a.m.
  • 99054: Services requested on Sundays and holidays.

Note that no value is set for these codes, so use good judgement when deciding what to charge.

Is it okay to email records?

Question: 

Our EHR software says that one way to meet meaningful use is for us to be able to provide patients with timely electronic access to their records via email. I read somewhere that emailing patients is not recommended because both parties emails must be encrypted, but we don't know if the patients email is encrypted, therefore we should not do this. Do you know of other ways to meet this requirement for the EHR?

Answer: 

It is true that one way to provide timely access to electronic EHR is through the use of email, however, the lack of encryption makes this risky. The only way around this is for the patient to sign a release which states that they understand the risks of unencrypted emails and that they assume that risk and choose to have that email sent anyway. The release needs to use a plain english explanation of why unencrypted emails are not secure so that the patient really understands their risk. Give them the option to obtain it some other way such as coming into your office to pick up a disk.

Coding for two Chiropractic Adjustments (same day)

Question: 

We have a patient who on two separate occasions came in in the morning for a chiropractic adjustment and then in the afternoon of the the same day for another chiropractic adjustment.  Do I need to use a modifier on the second chiropractic adjustment when this happens?

Answer: 
Yes.  The modifier is -76, which is for "repeat procedure by same physician".  Note that some payers (i.e. Medicare) only allow one CMT per day, so you may get denied.
 

Quick Questions

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After-hours office visits

Is there a code to bill to insurance for after-hours office visits?

read more...read more...

Is it okay to email records?

Is it okay to email records?

Our EHR software says that one way to meet meaningful use is for us to be able to provide patients with timely electronic access to their records via email. I read somewhere that emailing patients is not recommended because both parties emails must be encrypted, but we don't know if the patients email is encrypted, therefore we should not do this. Do you know of other ways to meet this requirement for the EHR?

read more...read more...

Coding for two Chiropractic Adjustments (same day)

We have a patient who on two separate occasions came in in the morning for a chiropractic adjustment and then in the afternoon of the the same day for another chiropractic adjustment.  Do I need to use a modifier on the second chiropractic adjustment when this happens?

read more...read more...

Billing 98943 and 98941

Did Medicare pass a change on billing 98943 extremity adjustment with a 98941 manipulative adjustment?  Is the modifier 51 still required when billing with the 98941 manipulative adjustment?  Also, have all insurance companies accepting this change?

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If orthopedic tests are negative

If orthopedic tests are negative, do you need to still list them in your treatment notes?

 

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I electronically sign my records; but if I find a mistake

I electronically sign my records; but if I find a mistake, I re-enter the SOAP notes for the same date and add the correction because once the records are electronically signed, you cannot change them; Is that OK for Medicare purposes to duplicate the SOAP notes twice to fix the error ?  

 

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What percentage of improvement is REQUIRED

What percentage of improvement is REQUIRED using outcome questionnaires for Medicare to support treatment and how often do we need to do Outcome Assessment questionnaires; every 2 weeks or every 4 weeks?  

 

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Should I have the patient sign an ABN for every adjustment, just in case?

I want to be able to collect from a patient if Medicare does not pay.  Medicare seems to deny care at random.  Should I have the patient sign an ABN for every adjustment, just in case?

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What if my Medicare patient refuses to fill out the outcome assessment questionnaire?

What if my Medicare patient refuses to fill out the outcome assessment questionnaire?

 

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Our Medicare contractor is auditing claims with 98942

Our Medicare contractor is auditing claims with 98942. Do you have any suggestions for a template for documentation to warrant the use of 98942?

 

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Is it okay to download the outcome assessment questionnaires

Is it okay to download the outcome assessment questionnaires or must we legally order them from somewhere, and if so, where do we order them?

 

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Where can you get a list of standard chiropractic abbreviations?

Where can you get a list of standard chiropractic abbreviations?

 

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If the patient signs an ABN at beginning of treatment plan

If the patient signs an ABN at beginning of treatment plan, do they need to sign a new one when they go on maintenance? Or is the one they signed okay since maintenance care is listed on it?

 

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I sometimes forget to sign my treatment note each visit.

I sometimes forget to sign my treatment note each visit. If records are subpoenaed can I go back and sign each treatment note prior to copying?

 

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For Medicare, do we have to provide diagnosis codes for the sacrum, lumbar and pelvis for a 98941?

For Medicare, do we have to provide diagnosis codes for the sacrum, lumbar and pelvis for a 98941?

 

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