Question: Dr. Kotlar, “My recordkeeping, coding, and collection systems are outdated. I’ve been documenting the same way for the last eight years even though I’ve added more services and products. I am seeing more patients but not collecting more money. Can you share some tips to help me improve?”
Read More
Although multiple segments or regions may be involved in the cause of a patient’s ailment, it is important to identify the main segment or region and report the diagnosis specifically. Medicare has recently reaffirmed that duplication of diagnoses in Box 21 on the claim form will be denied. Each area treated must have a unique diagnosis.
Read More
The demands of practice can often be daunting. We know we should take care of ourselves and take a break once in a while. Getting away is not always practical. Overhead is still present, the staff doesn’t always keep to our schedule because of family obligations, and of course, the patients seemingly want us on call 24/7. We can hire another doctor to practice in the office with us, but it is hard to find someone that the patients love who practices in the same style as we do. Then, of course, we have government and insurance regulations. Certification for another doctor for Medicare, PPO restrictions and credentialing can be tedious, especially when we just want them to fill in on a temporary basis.
Read More
Some time ago I worked with a client who needed help with an appeal. The provider had seen a patient over the course of four weeks for severe low back pain with radiculopathy to the left calf and foot. The provider put together a care plan and outlined goals based upon functional deficiencies. At each encounter, the following codes, among others, were billed:97110 Therapeutic exercises, 97140 Manual therapy. The therapy services were denied for most of the visits. The claims reviewer provided the following partial explanation for the denial:
Read More
In addition to the looming changes with BCBS-IL and Orthonet, Cigna and ASHN, and other carriers, there are a number of other changes.
Read More
National Government Services modified the chiropractic Local Carrier Determination for our region, and the changes are positive for chiropractic.
Read More
The ICS previously announced that NGS would be making significant changes to the chiropractic Local Carrier Determination (LCD) for our region.
Read More
Many are seeing increased denials of care for medical necessity in Medicare. A closer look at the reasons for the denials reveals a change in Medicare’s interpretation of medical necessity and progress in care. The evolution of their interpretation actually complements what chiropractors have been saying for several years – we do not only treat pain!
Read More
