Modifier Coding Archives - Chiropractic Coding and Billing

Date:March 22, 2023Posted By:ccadminCategory:ArticleTag:All Specialties, Appeals, Auditing, CMS|Medicare, Coding, Denial Management, Modifier Coding, MUE - Medical Unlikely Edit, Practice Management

Denials Due to MUE Usage – This May be Why!

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 …

Date:July 13, 2022Posted By:ccadminCategory:ArticleTag:Chiropractic, Coding, CPT Coding, Documentation, ICD10CM Coding, Medicare, Modifier Coding, Physical Medicine|Physical Therapy

Billing and Documenting for Therapeutic Exercises versus Therapeutic Activities

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:

Date:April 8, 2021Posted By:ccadminCategory:ArticleTag:Billing, Coding, CPT Coding, E+M Documentation and Coding, Modifier Coding, Procedure Coding, Radiology

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.

Date:December 31, 2020Posted By:ccadminCategory:ArticleTag:Chiropractic, CPT Coding, E+M Documentation and Coding, HCPCS Coding, Modifier Coding

CMS Final Rule Changes E/M Reporting Guidelines

Just when we thought we had figured out Evaluation and Management (E/M) reporting for 2021, CMS released their final rule and now we will need to make some adjustments. While CMS stated that they were adopting the AMA guidelines for E/M office or other outpatient services, they did make a few changes.

Date:September 30, 2019Posted By:ccadminCategory:ArticleTag:Claims Processing, CPT Coding, E+M Documentation and Coding, Modifier Coding, Procedure Coding

Q/A: How Do I Bill a House Call?

Question
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?
Answer
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 …

Date:March 5, 2018Posted By:ccadminCategory:ArticleTag:CPT Coding, Modifier Coding, Physical Medicine|Physical Therapy, Procedure Coding

Increased Therapy Denials Create Administrative Burden

Recently, many healthcare providers have begun to experience a downpour of denials when billing therapy services. The states which seem to be experiencing the most difficulty are Illinois, Oklahoma and Texas, particularly for claims submitted to BCBS plans owned by Health Care Service Corporation (HCSC). Since HCSC also owns Blues …

Date:December 21, 2016Posted By:ccadminCategory:ArticleTag:Billing, Coding, CPT Coding, Denial Management, E+M Documentation and Coding, Modifier Coding

Q/A: E/M Bundled with CMT

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.?