On August 3, 2020, the proposed Medicare Physician Fee Schedule for 2021 was released. This 1,355 page document includes some sweeping changes to the Medicare program. There are a few items in particular which should be noted by chiropractic offices.
Many large private payers recognize the potential cost savings and improved health outcomes that telemedicine can help achieve, therefore they are often willing to cover it. While there are several considerations, there could be certain circumstances where telemedicine might apply to chiropractic care.
Can chiropractic offices bill code 99211? Technically it can be used by chiropractors, but in most instances, it is discouraged. Considering that 99211 is a low complexity examination for an established patient, this code is not really made for the physician to use. In fact, in 2021, changes are coming for this code…
If a provider makes a house call to/for a patient, is there a way that it is represented on the claim form? A modifier, or something else?
Modifiers are not used to identify that a service was performed in the patient’s home. However, other modifier rules must be followed (e.g., modifier GP …
Have you ever had a patient take more time with the provider than they were scheduled for? Do you understand which codes to report and the rules that govern them to allow for better reimbursement?
Prolonged Service codes were created just for that reason but you must carefully follow the documentation …
On July 29, 2019, CMS released their proposed rule for the Medicare Physician Fee Schedule for 2020. Last year’s final rule “finalized the assignment of a single payment rate for levels 2 through 4 office/outpatient E/M visits beginning in CY 2021.” It also changed some of the documentation requirements (e.g., …
Is “noncontributory” really an unacceptable word to describe a patient whose family history doesn’t have any bearing on the condition being evaluated and treated today?
As many of you may already be keenly aware, there have been ongoing problems with many payers (e.g., BCBS of Ohio) regarding the appropriateness of reporting an E/M visit on the same day as CMT (CLICK HERE to read article). The AMA recently released an FAQ which renders their opinion …
The Evaluation and Management service is an important part of an episode of care.
It is the initiation of care and determines the scope and severity of the patient’s
condition. Dr. Ron Short will review the levels of Evaluation and Management
codes and which are appropriate in the chiropractor’s office. In this webinar you
What constitutes a new patient
Which Evaluation and Management codes should not be used
When to use the consultation code
What changes are coming to Evaluation and Management coding
The waiting is over, the Final Rule for CMS’ 2019 Medicare Physician Fee Schedule (MPFS) is available – all 2,379 pages for those looking for a little light reading. As anticipated, there are some pretty significant changes. Most of us were carefully watching the proposed changes to the Evaluation and …