Medicare creates and maintains the National Correct Coding Initiative (NCCI) edits and NCCI Policy Manual, which identify code pair edits. When performed on the same patient, on the same day, and by the same provider, the secondary code is considered an integral part of the primary code, and payment for …
Topic: Electrical Stimulation (EMS)
Question: An orthopedic surgeon/IME recommended a denial for all electrical stimulation
(EMS) by stating that “according ODG electrical stimulation is experimental therefore not
medically necessary or eligible for reimbursement.” Is that true?
Are you having a difficult time getting reimbursed? Are claims being denied because the insurance classifies everything as maintenance?
Audits are on the rise and the last you want to do is get tangled up in a fight over money you have already been paid. A smart chiropractor will audit himself to make sure there is little for the insurance companies to find when they strike.