Q/A: Why is Code 99080 Being Denied when Billed with an E/M Service? Posted on March 21, 2018 at 03:13:30 pm To properly answer the question, it is important to first review the requirements of selecting the appropriate level of Evaluation and Management (E/M) service and how that relates to reporting a 99080 special report […]

Anthem Will Not Give Modifier 25 a Pay Cut Anthem’s original plan was to take a 50% reduction when providers reported claims using modifier 25, it was then lowered to a 25% reduction and has now been fully rescinded, to the relief of providers.  The policy was to go into effect March 1, 2018, however, due to […]

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 plans in Montana […]

CPT Coding Update: Checkout for Orthotic There is a new CPT code for 2018. Anyone who uses Durable Medical Equipment, including Orthotics, and has billed for a “check-out” where the patient ran into a problem and required your attention, or that you re-checked the usage, fit, etc. Delete your Orthotics Check-Out Code effective December 31, […]

HARD CAP ON THERAPY SERVICES NOW IN EFFECT.   You must follow ABN procedures.   As we reported in December, the allowed dollar amount for 2018 for outpatient physical therapy and speech-language pathology combined is now $2,010 with a separate $2,010 for occupational therapy. Due to Congress’s failure to provide for an exception process (KX) a hard cap for […]

Your Chiropractic Practice Model: More Options than Ever Before The result of the increased diversity in practice models means that chiropractic patients have more options than ever before in how and where they access chiropractic care. This presents a significant opportunity for chiropractors who are willing to step out of their traditional comfort zone and […]

Your Chiropractic Practice Model: Hospital Based Chiropractic Practice More and more hospitals are incorporating chiropractic into their programs. This model includes both granting chiropractors’ hospital privileges as well as the establishment of on the premises or free standing hospital-owned chiropractic clinics. As the demand for chiropractic services increases, hospitals have discovered that having a chiropractor […]

Your Chiropractic Practice Model: Multidisciplinary/Integrative Practice The addition of other licensed professional disciplines to a chiropractic practice results in the multidisciplinary practice model. The most common disciplines encountered in this model are massage therapists, acupuncturists, physical therapists and nutritionists. The delivery and coordination of care between multiple disciplines in one location decreases the loss of […]

Your Chiropractic Practice Model: Multi-Specialty Group Chiropractic Practice As more chiropractors consolidate into group practices, many have found differentiation through the group multi-specialty practice. This practice model is comprised of a group of chiropractors with specialized training and certification in orthopedics, nutrition, pediatrics, sports, rehabilitation, and primary care to name a few of the most […]

Revised ABN and Non-Participating Provider Effective June 21, 2017, providers need to begin using the new ABN form. Be sure that new ABNs are properly delivered for any Medicare patients seen since June 21st. Non-participating providers need to note some specific instructional additions to the ABN which states the following (highlight emphasis added): Special guidance ONLY for non-participating suppliers and providers (those who don’t […]

Your Chiropractic Practice Model: Solo Chiropractic Practice The new health care economy has created an unprecedented diversity in practice models as practitioners evolve the manner in which health care is provided to the public. Chiropractic has come a long way from its isolated status of the past, entering and leading in areas that were previously […]

Your Chiropractic Practice Model: Accountable Care Organizations An accountable care organization (ACO) is a type of payment and health care delivery model established by the Centers for Medicare & Medicaid Services. It ties provider reimbursements to quality metrics and reductions in the total cost of care for an assigned population of patients. While chiropractors are not eligible […]

Your Chiropractic Practice Model: Medical Home Model  The medical home also known as the patient-centered medical home (PCMH), is a team based health care delivery model led by a physician that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. The PCMH has been proposed as a model […]

Multidisciplinary Practice: Don’t Wing It Tip 2 Don’t know the staffing requirements? The professionals most frequently associated with chiropractors in a multidisciplinary setting are Massage Therapists (21.3%), Medical Doctors (12.3%), Physical Therapists (11.2%), and Acupuncturists (9.0%). State-specific Chiropractic, Medical, and Physical Therapy Practices Acts regulate the scope of practice of each of their respective professions. […]

The Physician Compare Website Physician Compare 30-Day Preview Period Extended to 12/1/17 On October 18, CMS opened the 30-Day Preview Period for the 2016 performance information targeted to be publicly reported on Physician Compare starting in December 2017. The preview was scheduled to end on November 17 at 8pm ET. Due to a technical issue preventing the data […]

Multidisciplinary Practice: Don’t Wing It Tip 1 As multidisciplinary practice has increased in popularity over the last few years, I have become aware of a troubling trend. More and more chiropractors are undertaking the conversion of their chiropractic practice into a multidisciplinary practice without the legal and managerial assistance of professionals experienced in this highly […]

Expand Your Services and Add New Technologies Expand Your Services One way to grow your practice is by offering new products services. There are many services that are compatible with chiropractic care. Nutritional supplements, orthotics and supports are natural compliments to chiropractic care. Massage therapy, acupuncture and exercise therapy are high demand procedures that fit […]

How to Make Your Chiropractic Practice Grow – How to Maintain Current Patients and Attract New Patients Maintain Current Patients Although it is normal to lose some patients, you can advance your chiropractic practice by maintaining as many as possible. According to expert practice builders, twenty-five percent of your marketing efforts should be focused on […]

National Chiropractic Health Month 2017: Campaign Toolkit re you a member of the public who would like more information about how chiropractic services may help reduce/eliminate the need for opioids? Click here!  During National Chiropractic Health Month (NCHM) 2017 this October, the American Chiropractic Association (ACA) will share back injury prevention and strengthening tips as well as […]

How to Make Your Chiropractic Practice Grow – Market Internally Internal marketing and word-of-mouth advertising are the best two ways to attract new patients. They are also the least expensive methods of advertising. Word-of-mouth is spread mostly by people who come to you for chiropractic services and are pleased with your work. Patients who are […]