Medicare Improper Payment Report — Chiropractic 2019 to 2021
How did you do? Take a look at the Improper Payments Report and see where there can be improvement in your practice.
Medicare Improper Payment Report (2021)
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 . . .
Coding for a Performance of an X-ray Service vs. Counting the Work as a Part of MDM
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…
Are Excludes1 Edits Causing Problems?
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.
Watch out for New ICD-10-CM Codes
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.
Chronic Pain Coding Today & in the Future
Properly documenting and coding chronic pain can be challenging. As is commonly the case with many conditions, over the years, there has been a shift in the identification of different types of pain, including chronic pain. Understanding where we are now and where we are going will help your organization prepare for the future by changing documentation patterns now.
Intersegmental Traction — What’s Happening with Roller Tables?
Intersegmental traction therapy via the use of roller tables has been used by doctors of chiropractic for many years. Recently, questions have arisen regarding the appropriate billing of roller tables. This is largely due to the statement published in the July 2020 CPT Assistant published by the American Medical Association (AMA). Which code should you really be using?
Properly Reporting Imaging Overreads (Including X-Rays)
hile many provider groups offer some imaging services in their offices, others may rely on external imaging centers. When the provider reviews images performed by an external source (e.g., independent imaging center), that is typically referred to as an overread or a re-read. Properly reporting that work depends on a variety of factors as discussed in this article.
Evaluation & Management (E/M) Webinar Q/A
Find answers to some questions asked by attendees of our recent webinar regarding the changes released by the AMA in their March 9, 2021 Errata and Technical Corrections document in relation to Evaluation & Management (E/M).
Q/A: Why is My Claim Being Denied When I Report a Secondary Diagnosis Code?
Question: Recently my claims to Medicare are being denied when I submit a secondary diagnosis code. I’ve heard that this is happening in several states including Washington, California, and New York. Has there been a recent change in what secondary diagnosis codes are allowed?
