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 …
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.
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.
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?
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.
The new year is coming. Are you ready? Do you know which codes have changed? Do you know which issues are the focus of payers and auditors? Have you conducted annual reviews to make sure nothing is falling through the cracks? Join Dr. Gwilliam of PayDC Software, as he helps you prepare for 2018.
Q: An insurer told me that chiropractors cannot bill 99204 or 99214 because those exams “require a level of decision making that would typically only occur in an emergency room.” Is this true? Do I have any recourse?
What do you do when you are continually getting denials when billing office visit E/M code 99213-25 along with a CMT on dates that we do re-exams? What do you do when an appeal does not seem to work even though clear evidence has been provided that all conditions for the 99213 have been satisfied.?
