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