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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?
The CPT manual lists five spinal regions: cervical, thoracic, lumbar, sacral, and pelvic. Therefore, a 98941, spinal manipulation, three or four regions, would be the appropriate code for the example given.
Is there more specific codes for supplies rather than using 99070?
Yes. The HCPCS supply code series includes multiple more specific supply codes. The HCPCS supply codes are still too often overlooked and unused by providers. You will find that the HCPCS supply codes are more specific and as a result, often has more applicable codes for accurate reporting than the standard 99070 which is a non-specific, general supply code.
Of course, coverage and benefits for these HCPC codes, like all other codes, does depend upon policy benefits and limitations. Though you will likely find that when coverage does exist, it is generally much easier and more efficient to get reimbursed using a specific code for the supply versus using the general and ill defined supply code.
Note too that there are specific modifiers that can be used to even further define the supply and indicate whether the purchase was of New Equipment, a Rental, etc.
The HCPCS supply section starts on page I-8 of your 2014 ChiroCode Deskbook.
When initially submitting for a Medicare patient, what is the rule for filling out box 14? Also, what about box 15?
Medicare requires that box 14 must always be filled out. Even though the form field says Date of Current Illness, Injury, Pregnancy, chiropractic physicians are instructed to list the date of the initiation of the course of treatment. No qualifier is required for Medicare. This differs from other carriers where Box 14 is used to list the date of the incident, and qualifier 431 Onset of Current Symptoms or Illness may be appropriate. Box 15 is required to be left blank by Medicare. Here is a link for the CMS 1500 instructions.
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?
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?
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?
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 ?
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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