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Re: diag codes
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ifyxbax
Re: Chiro billing
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: 50
Sep 3 02 12:37 PM
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My Recent Posts
Jennifer
Your lack of biomechanical knowledge is showing. The knee bone is connected to the ??? bone, only kidding. I agree with the other Doc. Also is he wanted to do fraud he would use the 98942 code I think. Lastly, several years ago the Adjustment (97250)/OV combination was fairly accepted practice before the 9894* series was developed. Maybe he just hasnt kept up.
The spine functions biomechanically as a helix not according to some two dimensional regional concept administered by Medicare.
This Doctor is a full spine adjustor as are many if not most chiropractors.
This means that the Doctor makes medical decisions based on the biomechanics of that patient's whole spine, short leg adaptations, gait, scoliosis, segmental abnormalities, compensation patterns, muscular fiber tautness or laxness.
This means that according to the treatment protocol, if the Doctor doesnt adjust the cervical/thoracic compensatory changes when the patient has low back pain either the patient may develop neck/upper back pain or the low pain pain may reoccur or not resolve.
3-4 regions are adjusted in my practice 80% of the time. 5 regions 5% and one region 15%. When these codes were developed I read somewhere that HCFA thought that the 40 code would be used about 20%, 41 code about 70%, and the 42 code about 10%.
Medicare allows us to put the additional Dx's in line 19 in IL. For regular insurance, I put down the primary complaint in slot one followed by the 739 code for the primary region, number 3 is the FUNCTIONAL problem (spondylosis, stenosis, facet arthrosis, myofascitis, muscle spasms) and number four is 739 code for the next region that is most involved. This is the way I was taught and it may not be perfect.
Remember also that if the Doctor adjusts the lumbo-sacral region, the sacro-iliac region and a thoraco-lumbar jxn...that's 3-4. That is the one of the most common treatments due to the anatomy of the iliopsoas and he would only need one presenting complaint.
The ACA also puts out a nice manual just for these types of questions. Maybe this Doc should invest 50 bucks.
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Association News
Medical Billing & Coding Education from the MAB
Continuing Education
Management Advice and Training
Questions Asked More Than Once
Help Wanted - Billing and Coding
Non Billing Talk
The Venting Area (Clean posts please)
Medical Coding and Billing News
Fraud and Abuse
Health Insurance - Provider Contracting
ERISA
Tricare
Workers' Compensation
General Medical Billing Questions
Appeals
Accounts Receivables (A/R)
Refunds
Auto Accident Issues
Medisoft Technical Support
Medical Software Technical Support Questions Other than Medisoft. No Investigation Questions!
General Medical Coding Forum
CPT Coding Questions
HCPCS Coding Questions
ICD-9-CM Coding Questions
Evaluation & Management Coding Questions
Acupuncture Billing and Coding
Ambulance Coding and Billing
Cardiology Coding and Billing
Chiropractic Coding and Billing
Dental Billing and Coding
DME Coding and Billing
Emergency Department Coding and Billing
Family Practice Coding and Billing
Hospital Inpatient and Outpatient Coding
Hospital Billing, Appeals and Collections
Internal Medicine Coding and Billing
Laboratory Coding and Billing
Ophthalmology Coding and Billing
OB-GYN Coding and Billing
Pain Management Coding and Billing
Pediatric Coding and Billing
Podiatry Coding and Billing
Physical Therapy Coding and Billing
Psychiatry Coding and Billing
Radiology Coding and Billing
Surgery Coding and Billing
Neurology Coding and Billing
Urgent Care Coding and Billing
Provider Compliance
Billing Center Compliance
HIPAA
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