ICS Staff, Author at Illinois Chiropractic Society

BCBSIL Denial of Claims with Modifiers Update

Posted by ICS Staff | Mar 28, 2018 | Insurance, zall | 0 |

The ICS now has heard from numerous members about the significant financial and administrative impact on their practices, resulting from a BCBSIL claims processing protocol that began in November 2017. When applied, this claim edit, described by BCBSIL as “code-auditing enhancement” via “clinically validating modifiers,” automatically denies some providers’ claims on codes that require the modifiers 25 or 59 (including XE, XS, XP, XU). The EOBs state the reason for the denial as: “The procedure code is inconsistent with the modifier used or a required modifier is missing…,” even though the modifiers are both present and consistent with CPT® and other guidelines followed by BCBSIL.

PTs Seeking Direct Access to Patients

Posted by ICS Staff | Mar 14, 2018 | Frequently Asked Questions, ICS Message, Legislative, Members Only, zall | 0 |

Physical therapists in Illinois have introduced legislation, HB 4643 (Burke, D.), to allow physical therapists to independently treat patients(direct access) without a physician referral. This legislation would also allow physical therapists the independent authority to diagnose patients. Allowing a physical therapist to independently diagnose a patient would be unprecedented under Illinois law and would seriously compromise patient safety.

Who May Provide Dietetic and Nutrition Services in the Chiropractic Office? What Kinds of Dietetic

Posted by ICS Staff | Feb 14, 2018 | Clinical, Legal, Nutrition, Scope of Practice, zall | 0 |

“Dietetic and nutrition services” means the integration and application of food science and nutrition to individuals and groups. A chiropractic physician may provide dietetic and nutrition services, which includes nutrition counseling, assessment, and therapy. A chiropractic physician may also provide a medically prescribed diet (a diet in which nutrient levels need to be monitored, altered, or both, for an individual whose health is impaired by disease, injury or surgery), for any individuals other than residents of nursing homes.

BCBS Modifier Denial Update

Posted by ICS Staff | Feb 7, 2018 | Insurance, Insurance Appeals, zall | 0 |

Many chiropractic physicians around the State of Illinois have been receiving denials from BlueCross BlueShield of Illinois (BCBSIL) for services rendered and billed with modifiers 25 or 59 (including XE, XS, XP, XU). The Illinois Chiropractic Society informed doctors about BCBSIL’s announced claim processing change in December, and we have been working diligently on this ongoing issue since early December. Because of its importance to the ICS and its members, we want to share our updated efforts and information.

Has or Is Your Practice Moving or Changing Ownership?

Posted by ICS Staff | Jan 30, 2018 | Practice Management, zall | 0 |

CMS recently released a reminder regarding the requirement that providers must notify CMS of ownership changes within 30 days. In addition to changes in ownership, providers must report changes in address locations and any adverse legal action within 30 days. A recent OIG study showed that over 75% of owner names are substantially inaccurate across all Medicare and Medicaid provider types.

FAQ: Is Dry Needling in the Scope of Chiropractic Practice?

Posted by ICS Staff | Jan 24, 2018 | Acupuncture, Frequently Asked Questions, Legal, Scope of Practice, zall | 0 |

“Dry needling” is defined in the Illinois Physical Therapy Act as:“an advanced needling skill or technique limited to the treatment of myofascial pain, using a single-use, single insertion, sterile filiform needle (without the use of heat, cold, or any other added modality or medication), that is inserted into the skin or underlying tissues to stimulate trigger points.”

Medicare Fee Schedule and Locality

Posted by ICS Staff | Jan 3, 2018 | Frequently Asked Questions, Insurance, Medicare and Medicaid, zall | 0 |

Where can I find the Medicare Fee Schedule?

Hottest Issues in 2017

Posted by ICS Staff | Dec 27, 2017 | ICS Message, Practice Management, zall | 0 |

The Illinois Chiropractic Society has provided doctors across Illinois with critical information related to practice, treatments, examination, marketing, billing, coding, compliance, and more. Here are the top ten issues that you, our readers, found the most important in 2017: