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

How Long Must We Keep Records

Question: 

Q:  Our office is planning to dispose of aged patient records.  Is there a specific time frame that we are required to keep records for or  other rules that we should know about first?

Answer: 
A:  HIPAA regulation 164.316(b)(2)(i) requires that "HIPAA related documentation be retained for six years from the date of its creation or the date when it was last in effect, whichever is later"
Please see page 7 of the link for your office records and reference of this HIPAA guideline:  http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/pprequirements.pdf
HIPAA also has general guideline regarding records disposal that you should have on file and reference prior to making plans to dispose of any PHI or HIPAA related material.  That information is on this link:  http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/disposalfaqs.pdf
However, it is important to note that if your state guideline pertaining to this is more strict than HIPAA, you must adhere to that rule that is the most stringent.  In order to ensure compliance, providers must be aware of both the HIPAA guideline as well as that set forth by their state.  To learn state specific rules on this topic, searching the internet can generally provide the information needed or otherwise calling your local organization or board.  


Cox Flexion Distraction

Question: 

If I perform a regular high-velocity adjustment, side posture, on the low back, as well as COX distraction on the cervical region, may I bill a CMT code as well as 97140 for the flexion-distraction?

Answer: 

A COX technique is considered manipulative therapy and does not meet the criteria for 97140, manual therapy. Therefore, it would be inappropriate to bill this code for the COX technique.  The CMT code includes the work described above.

Chiropractors cannot Opt Out of Medicare

Question: 

I am looking for the specific wording from Medicare as to their “opt-out” policy with regards to Chiropractors. Can you provide that?

Answer: 

Opting out of Medicare is not an option for Doctors of Chiropractic. Note that opting out and being non-participating are not the same things. Chiropractors may decide to be participating or non-participating with regard to Medicare, but they may not opt-out. For further discussions of the Medicare “opt out” provision, see the Medicare Benefit Policy Manual (Chapter 15, Section 40; Definition of Physician/ Practitioner) at http://www.cms.hhs.gov/manuals/ downloads/bp102c15.pdf

Quick Questions

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How Long Must We Keep Records

Q:  Our office is planning to dispose of aged patient records.  Is there a specific time frame that we are required to keep records for or  other rules that we should know about first?

read more...read more...

Cox Flexion Distraction

If I perform a regular high-velocity adjustment, side posture, on the low back, as well as COX distraction on the cervical region, may I bill a CMT code as well as 97140 for the flexion-distraction?

read more...read more...

Chiropractors cannot Opt Out of Medicare

I am looking for the specific wording from Medicare as to their “opt-out” policy with regards to Chiropractors. Can you provide that?

read more...read more...

One-Region Adjustment or Three

If I treat a patient by performing a Chiropractic Manipulative Treatment (CMT) to the pelvic region, the sacrum, and L5, is this a one-region adjustment, or three?

read more...read more...

Supply Codes

Is there more specific codes for supplies rather than using 99070?  

 

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Medicare Rules for Box 14

When initially submitting for a Medicare patient, what is the rule for filling out box 14? Also, what about box 15?  

 

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After-hours office visits

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

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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?

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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?

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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?

 

read more...read more...
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