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E/M and CMT: A Guide to Help Chiropractic Physicians Get Paid for Both

By Evan Gwilliam, DC, MBA, QCC, CPC, CCPC, CPMA, CPCO, AAPC Fellow · September 17, 202518 min read
CPT and CMT codes
E/M and CMT: A Guide to Help Chiropractors Get Paid for Both
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Editor's Note: The ICS has an on-demand course with Dr. Gwilliam covering the entire -25 modifier issue and all of the tips here.

Background
CMT Components
When is an E/M Appropriate?
NCCI and the 25 Modifier
Tips for Countering Inappropriate E/M Denials
Medical Necessity is the Overarching Criteria
Final Thoughts
References

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About the Author

Dr. Gwilliam, Senior Vice President of Practisync, brings a wealth of expertise to the healthcare industry. Graduating as Valedictorian from Palmer College of Chiropractic, Dr. Gwilliam holds credentials as a Certified Professional Coder, Medical Auditor, and Compliance Officer. With a unique background combining clinical experience with a Bachelor’s degree in accounting and a Master’s of Business Administration, he is widely recognized as a leading authority in his field. Dr. Gwilliam's expertise extends beyond his executive role, as he is also a sought-after seminar speaker. He shares his insights on topics ranging from healthcare compliance to documentation and coding at prominent industry events. Additionally, Dr. Gwilliam provides expert witness testimony, conducts medical record audits, and offers tailored consulting services to healthcare providers seeking to enhance their practices. He has contributed to reference books and articles for multiple publications, cementing his status as a thought leader in the healthcare community. Learn more about Practisync here: https://practisync.com/

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