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

Where can I find reasonable and customary fees

Question: 

Where can I find reasonable and customary fees

Answer: 

There are many places to find usual and customary fees at a cost. I think we even carry a few in our book store. At ChiroCode and in our book we encourage you to use the Medicare fee schedule and a percentage of that to calculate your fees. There is a free calculator online for all 2014 ChiroCode DeskBook subscribers.
 
It allows you to increase the Medicare fee by specific percentages. Most private insurance companies and docs will fall between 175% and 250% of Medicare.

Are higher level codes more likely to get audited?

Question: 

I heard that higher level codes like 99204 and 99205 are more likely to get audited.  If I only use 99202 or 99203 will I be "under the radar"?

Answer: 

To find out more about this, check out this article from the AAPC: http://news.aapc.com/index.php/2014/04/undercoding-is-no-better-than-overcoding/comment-page-1/#comment-11190

Make sure to register for Dr. Grant's upcoming webinar here: https://www2.gotomeeting.com/register/176276682

When completing the new CMS 1500 form

Question: 

When completing the new CMS 1500 form:  If you have more than 4 diagnostic codes, do you list all of the codes or only the top four codes?  Also, if you do need to list all of the diagnostic codes, when listing the codes on the form (a,b,c,d, etc..), the box only accommodates up to 4 diagnostic codes.  How do you fit all of the codes in the box provided?

Answer: 

You can check the 2014 ChiroCode DeskBook for the current guidelines for the CMS-1500.  You should list all relevant diagnosis codes in box 21 (up to twelve), but in 24E you can only fit four diagnosis code pointers.  So, you should select the ones that apply to the procedure you performed.  It may be ABCD, but it could be BD, or EFG, or whatever fits the scenario.

Quick Questions

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Where can I find reasonable and customary fees

Where can I find reasonable and customary fees

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Are higher level codes more likely to get audited?

I heard that higher level codes like 99204 and 99205 are more likely to get audited.  If I only use 99202 or 99203 will I be "under the radar"?

read more...read more...

When completing the new CMS 1500 form

When completing the new CMS 1500 form:  If you have more than 4 diagnostic codes, do you list all of the codes or only the top four codes?  Also, if you do need to list all of the diagnostic codes, when listing the codes on the form (a,b,c,d, etc..), the box only accommodates up to 4 diagnostic codes.  How do you fit all of the codes in the box provided?

read more...read more...

What is the correct modifier to use when billing therapies to Medicare?

We are setting up a new computer system in the office and the trainer told us to use modifier -GP when billing therapies to Medicare with a secondary insurance. In the past we used -GA. Which is correct?
Are you supposed to put 2 modifiers in the case of -GA and -25 if billing an exam and an adjustment?
read more...read more...

Do Subluxation Codes Require Pain Codes?

 Am I supposed to attach a pain code to each subluxation code I use on a claim?

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Are Text Messages HIPAA Compliant

If I text my patients appontment times and reminder am I voilating HIPAA?

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Using your GEMs, Tabular List and Instructional Notes to Find ICD-10 Codes

I am looking for Intervertebral Foraminal (lateral recess) Stenosis (IVFS) codes for ICD10.  In your book (ICD9 to ICD10 Map) all I can find are spinal stenosis codes for IVFS.  We need more specific codes for IVFS.

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New Claim Form

 Can we use icd-9 forms until October 2014 or do we have to switch to icd-10 forms April 1st?

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What is the Purpose for the Increased Specificity of ICD-10?

What is the purpose for the increased specificity of ICD-10? In many cases, at least chiropractically, it won't affect treatment. Will the insurance/gov't use it to deny care?

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If a PI patient has Medicare, do I have to bill Medicare first?

If a PI patient has Medicare, do I have to bill Medicare first?  Do I have to accept the Medicare price?

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Medical Necessity

Q:  Is there a simple formula that I can use to show "medical necessity" so my notes will stand up to a review?

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Can I file a claim without an electronic submission method?

 I am new to Medicare.  Can I file a claim without an electronic submission method?  What form do I use?  Is it called the "HCFA"?

read more...read more...

The New CMS 1500 Claim Form

When is the use of the new CMS 1500 claim form going into effect?  Is it April 1, 2014?  Do you have the new claim form for purchase?

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Medicare Denials

I have a particular patient whose primary insurance is Medicare Railroad (which we are non-par with). This patient is a snowbird so he comes in for a few dates in the year. Every date of service is denied by Medicare RR with a request for supportive medical notes. Our notes have been denied and we are now being asked to appeal to Q2Administrators. The patient has recently come in again for the first time in 7 months and Medicare Railroad is asking for notes already. Should I keep billing to Medicare or just bill the patient? I am afraid of drawing red flags, which I feel we are doing by constantly appealing.

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Billing 97110

 

What are the allowable minutes needed when billing multiple 97110 exercises on a patient and what is the procedure for billing this code with a modifier 51 and 59? Also, how many units are normally allowed when performing these on one area of the body as opposed to 2 or three areas?

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