Posted 10/29/2017 by admin

Data Precision 3500 Manual Lymphatic Drainage

Data Precision 3500 Manual Lymphatic Drainage Rating: 9,9/10 9044votes

Title: Chiropractic Coding, Audits, & Compliance 1 Chiropractic Coding, Audits, Compliance • Jeffrey Randolph, Esq. • T 201-505-1733 • Emailjrandolph_at_labadyandrandolph.com 2 Current Procedural Terminology (CPT) Codes • CPT is the coding language spoken between all health care providers and insurance companies that allows reimbursement for services rendered. • There are over 7,500 CPT codes but chiropractors typically only use 25-30 codes the majority of the time in daily practice.

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Indications For Manual Lymphatic Drainage

• Chiropractic Manipulative Treatment CPT Codes were established around 1996-97. • A modifier is a numeric or alphabetic appendage to a CPT code which notifies the payor that the code does not meet the exact CPT definition. CPT 99201-25) 3 CPT Codes (contd) • CPT Codes are updated by the AMA CPT Editorial Panel. • The panel consists of • 11 physicians from the AMA • 4 Members from the insurance carriers and Hospital Association • 2 Members from the Healthcare Professionals Advisory Committee 4 National Correct Coding Initiative(NCCI) • The NCCI is a federal program that establishes a system of coding edits used across the nation by Medicare.

• The NCCI determines which codes for Medicare reimbursement purposes should not normally be separately reimbursed and bundles their reimbursement together. 5 ICD-9-CM Diagnosis Codes • International Classification of Disease Clinical Modification is a standardized coding of patient diagnoses. • You must place the appropriate ICD-9 diagnosis codes in Box 21 of the CMS-1500.

• Your diagnosis codes must support the billing codes you use. I.e., if you bill for an extra-spinal shoulder adjustment, a shoulder diagnosis must be issued and linked to the procedure code. 6 CPT Codes for Chiropractors • There are three major general classifications of codes chiropractors typically bill • 1) Evaluation Management (E/M) • e.g. 99201 new patient eval.

• 2) Chiropractic Manipulative Therapy (CMT) • e.g. 98942 5 region manip. • 3) Physical Modalities • e.g. 97012 mech traction 7 Evaluation Management (E/M) Codes • New Patient E/M 5 • Established Patient E/M 5 • Patient Consultation E/M 5 8 New Patient E/M(5) • Used when you first treat a patient that is not a consultative referral. • A patient is new if they have not received care by you or your group practice within the past 3 years.

• Three major components • 1) History • 2) Exam • 3) Medical Decision Making 9 New Patient EM Levels 1-5 • CPT HISTORY EXAMINATION MDM • 99201 Problem-Focused Problem Focused StraightFor. • 99202 Expanded P-F Expanded P-F Straightfor • 99203 Detailed Detailed Low Complex • 99204 Comprehensive Comprehensive Mod. • 99205 Comprehensive Comprehensive High Complex. • (NOTE Time spent is no longer a key component since 1992) 10 EM for Established Patients(CPT 5) • Any patient treated by your or your group practice in the past 3 years. • Should be performed every 12 visits or 30 days (not every visit). 11 Consultations (5) • May be used with new or established patients.

• Patient must be referred to you by another practitioner for your professional opinion. • Same 3 key components (History, Exam, Medical Decision Making) • Must send a written report to referring practitioner. • Must identify referring practitioner in Box 17 of CMS-1500 UPIN in Box 17a. 12 Chiropractic Physical Modalities 13 Chiropractic Manipulation • CPT Manual divides the spine into 5 regions. • Five Spinal Regions • 1) Cervical (including atlanto-occipital joint) • 2) Thoracic • 3) Lumbar • 4) Sacral • 5) Pelvic 14 Extra-Spinal Manipulation • The AMA CPT Manual divides the body into 5 extra-spinal areas • 1) Head (including TMJ) • 2) Lower Extremity • 3) Upper Extremity • 4) Rib Cage • 5) Abdomen 15 Primary Chiropractic Codes • CPT 98940 1-2 Region CMT • CPT 98941 3-4 Region CMT • CPT 98942 5 Region CMT • CPT 98943 Extraspinal (1 or more regions) • NOTE Medicare only reimburses for CPTs 2. • When Billing a CMT Extraspinal on same visit, use modifier -51 on the extraspinal (i.e. 16 CMT E/M Billing • If E/M and CMT are performed on the same date, bill with a modifier -25 to indicate a significant separately identifiable service • AMA CPT Manual CMT codes include a pre-manipulation patient assessment.