Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder

Coding Clinic Officially Defines Spondylolisthesis and Disc Disorder The Coding Clinic for ICD-10-CM and ICD-10-PCS is a quarterly newsletter published by the American Hospital Association’s Central Office (AHA). The information they publish is a joint effort of several organizations including the Centers for Disease Control and Prevention (CDC), the National Center for Health Statistics (NCHS), the Centers […]

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Chiropractic Symposium Brings Top Chiropractors Together

Chiropractic Symposium Brings Top Chiropractors Together  The top chiropractors from across the United States will join together in the “Expanding Your Practice Symposium” on November 9-11 in Orlando, Florida. The purpose of the conference is to bring together chiropractors and their staff members in a setting that allows them to share their experience and expertise […]

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CMS Proposes Changes to Evaluation & Management Requirements

CMS Proposes Changes to Evaluation & Management Requirements It is no secret that providers have long argued that E/M coding is burdensome and does not truly reflect the services provided. This fact is acknowledged by CMS with the following statement “Prior attempts to revise the E/M guidelines were unsuccessful or resulted in additional complexity due […]

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Exosomes: How Stem Cells Work

Exosomes: How Stem Cells Work Stem cells are unique cells with amazing healing capabilities, it’s only been in the last decade that a substantial number of scientists are investigating and providing insights on how to use them most effectively with the help of clinicians having “boots on the ground” actually witnessing the effects and what […]

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2018 MIPS Eligibility Tool

2018 MIPS Eligibility Tool CMS has released the updated MIPS Participation Lookup Tool for 2018 eligibility for the Merit-based Incentive Payment System (MIPS). Enter your NPI to determine whether you need to participate during the 2018 performance year. CMS changed the eligibility threshold for 2018: Clinicians and groups are now excluded from MIPS if they 1) billed […]

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Blue Cross Blue Shield Association Affirms Opioids Should Not Be Prescribed as First or Second Lines of Pain Therapy

Blue Cross Blue Shield Association Affirms Opioids Should Not Be Prescribed as First or Second Lines of Pain Therapy Subtitle Professional standards require alternative therapies designed to limit harm to Blue Cross and Blue Shield members Chicago – The Blue Cross Blue Shield Association (BCBSA) National Council of Physician and Pharmacist Executives (NCPE) at its March […]

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Q/A: Why is Code 99080 Being Denied when Billed with an E/M Service?

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 […]

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Anthem Will Not Give Modifier 25 a Pay Cut

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 […]

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Increased Therapy Denials Create Administrative Burden

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 […]

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CPT Coding Update: Checkout for Orthotic

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, […]

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HARD CAP ON THERAPY SERVICES NOW IN EFFECT  

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 […]

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Your Chiropractic Practice Model: More Options than Ever Before

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 […]

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Your Chiropractic Practice Model: Hospital Based Chiropractic Practice

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 […]

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Your Chiropractic Practice Model: Multidisciplinary/Integrative Practice

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 […]

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Your Chiropractic Practice Model: Multi-Specialty Group Chiropractic

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 […]

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Revised ABN and Non-Participating Provider

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 […]

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Your Chiropractic Practice Model: Solo Chiropractic Practice

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 […]

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Your Chiropractic Practice Model: Accountable Care Organizations

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 […]

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Your Chiropractic Practice Model: Medical Home Model 

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 […]

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Multidisciplinary Practice: Don’t Wing It! – Tips 4 & 5

Multidisciplinary Practice: Don’t Wing It! Tip 4 & 5 Don’t know the costs? Without proper management, the increased overhead associated with additional professional staff members can drain your bottom line and tax your ability to produce a return on your investment. In the area of financial management, it is essential to seek professional advice. Before […]

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OUR ALLIANCE PARTNERS

THE BENEFITS OF BECOMING A
BREAKTHROUGH COACHING PARTNER

As a leader in the Chiropractic profession, BTC has been extremely selective in forming its group of alliance partnerships. We encourage you to visit our partner's websites and to utilize their services and products. When you become a Member of Breakthrough Coaching you become part of a special "family" unlike any other in the Chiropractic Profession.