Billing Spinal X-Rays

Full spine x-rays are not considered to be of diagnostic quality. This is expecially true of 14×36 film. So if a chiropractor decides to x-ray the patient’s entire spine, he should take sectional views and bill the exam using three codes as follows: 72040 Radiologic examination, spine, cervical; 2 or 3 views 72070 Radiologic examination, […]

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Railroad Medicare

Individuals who have worked 10 or more years of railroad service receive their Medicare benefits through the Railroad Retirement Board (RRB) instead of the Centers for Medicare and Medicaid Services (CMS). The Railroad Medicare card has the Railroad Retirement Board logo in the upper left hand corner instead of the HHS logo and “RAILROAD RETIREMENT […]

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GP Modifier for Therapies

Insurance policies are written in segments or riders. Chiropractic services are covered under the chiropractic or physician portion of the policy but therapies are generally covered under a therapy portion. The therapy portion of the policy covers all therapy no matter who provides the service. This means that when a patient comes to you they […]

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Billing X-rays To Medicare

If diagnostic services are shown on the claim form, the ordering physician’s name should appear in block 17 and his NPI number in block 17b. Block 17 should be qualified with DK which indicates that the chiropractor is the Ordering Provider. The only diagnostic services that a chiropractor will probably do is x-rays (and blood […]

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Important Medicare Legislation

Legislation championed by ACA to increase Medicare coverage of chiropractic services has been introduced in the U.S. House of Representatives. The Chiropractic Medicare Coverage Modernization Act of 2019 (H.R. 3654) would allow Medicare beneficiaries access to the chiropractic profession’s broad-based, non-drug approach to pain management, which includes manual manipulation of the spine and extremities, evaluation […]

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Tax ID, NPI, UPIN, PTAN, Provider and Taxonomy Numbers

Zero State Before you begin treating patients, you should setup the structure of your practice. First off, you should decide if you want to incorporate. A corporation provides a layer of protection for your assets. The laws governing incorporation vary state to state and there are multiple types of corporations so this decision should be […]

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Modifiers 25 and 59

Modifiers are used to indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code. Under normal circumstances, an Evaluation and Management service (E/M – exam) is filed without a modifier (99203 in this example).         However, […]

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Medicare Overpayments

A Medicare overpayment is a payment that exceeds amounts properly payable under Medicare statutes and regulations. When Medicare identifies an overpayment, the amount becomes a debt you owe the Federal government. Federal law requires the Centers for Medicare & Medicaid Services (CMS) to recover all identified overpayments. Medicare overpayments commonly occur due to: Incorrect coding […]

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Secret Income for Auto Accident Cases

When a vehicle is rented, the person renting the vehicle can purchase insurance from the rental company or use their own insurance. At the time of the rental, the person or persons who will be operating the vehicle are identified (or designated) to the rental company. If your patient has been injured by a rented […]

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