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Re: diag codes
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medfileca
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Sep 8 02 1:46 PM
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Cynthia,
Wow - what a discussion you opened! I am also having the same conversation with two of my clients. One client bills 98941 for every visit, as he does adjust 3-4 regions for every patient. The other client bills 98940 for every patient because he does not want his patients to feel he is gouging the insurance companies.
I understand the full body adjustment - the cervical region is connected to the thoracic region and so on. Any cervical ailment must affect all areas of the body, and vice versa. Problems can be referred from or refer to all areas of the body. I have been going to a chiropractor for 30 years, and I have always had a full body adjustment, no matter where the complaint was. Just good medicine I think.
On the insurance billing side - I do not care that he does adjust all areas and it is documented in all of the charts. It matters what the insurance company is looking for, and what the patient says if the insurance company calls them. Which they do!
I spent a day a week for 1 month at the desk
when I first signed up this client (I try and do this for all clients at least twice to meet patients and see how the office runs. They seem to really like it.), and in an indirect conversation with the patients, they are clear that they have had a full body adjustment. Knowing that the same treatment for most patients will trigger and audit, my client is still unwilling to bill differently as he does do the work. I just let him know that if he is audited, they will not leave without a piece of his practice.
The same goes for the client who bills 98940 all the time. He is under billing! It does not matter, as it is the consistent use of the same codes for all that trigger the audit. I just make sure the charts are in order, there is no fraud or abuse and my clients are informed.
Best of luck,
Catherine
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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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diag codes
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