CMS assigns Medically Unlikely Edits (MUEs) for HCPCS/CPT codes, although not every code has an MUE. MUE edits are used to limit tests and treatments provided to a Medicare patient for a single date of service or for a single line item on a claim form. It is important to understand MUEs are …
Just when you think you are finally getting the hang of the E/M coding changes that became effective on January 1, 2023, the AMA announced further revisions on March 1, 2023 which are retroactive to January 1, 2023. This article discusses the changes in the March 3, 2023 CPT Errata & Technical Corrections and also includes a preview of upcoming 2024 changes.
There were several changes to the ICD-10-CM codeset for 2023 which went into effect October 1, 2023 and could impact chiropractic. At the time of publication, it was unknown how payers would respond to these changes. This article only discusses some of the changes to the ICD-10-CM codes. Changes to procedure codes such as “Prolonged Services” for office E/M visits are included in the 2023 ChiroCode DeskBook.
Chiropractors treat, among other things, issues with the musculoskeletal system. Active therapeutic procedures are accepted as effective ways to treat many common conditions and therefore can be billed and generate revenue for a clinic. Two common CPT codes that might be used in a chiropractic setting include:
How did you do? Take a look at the Improper Payments Report and see where there can be improvement in your practice.
The Medicare Improper Payment Report does not measure fraud, but rather, it estimates the payments that did not meet Medicare coverage, coding, and billing rules. The estimated Medicare FFS payment accuracy rate (claims paid correctly) from July 1, 2019 through June 30, 2020, was 93.74%, which is up slightly from last year. The estimated improper payment rate (claims paid incorrectly) was . . .
When x-rays are audited on the same date as an E/M encounter we have one of three decisions to make about the work that went into the radiological exam when the practice owns x-ray equipment and does their own interpretations internally. First, we must determine whether the x-ray was…
Excludes1 edits can cause problems with claim denials. It is important to watch for annual changes to the Excludes1 and Excludes2 edits. Know the rules to properly submit and appeal claims.
New ICD Codes for: Low Back Pain, Cervicogenic Headache, Non-Radiographic Axial Spondyloarthritis (nr-axSpA), and Social Determinations of Health (SDOH). These codes became effective on October 1, 2021.
The “Medicare Advance Written Notices of Non-coverage” booklet, published by CMS’s Medicare Learning Network, was updated. This article discusses the changes to this booklet regarding the use of the ABN.
