Forum - Questions & Answers

May 19th, 2010 - marsharalston

What is the correct coding of ; 76140

I work for a chiropractor who sends the patient out for xrays at a local walk in/ urgent care center for xrays.The patient brings the cd of the xrays back to him and he goes over the xray and gives them a report. What is the correct CPT4 code for this report of findings? We are using 76140. the other chiropractor in our group says to use the xray code with modifier 26. which is correct.

May 19th, 2010 - nmaguire   2,606 

payer

You will get nothing from Medicare. Payment for a Chiropractor will depend on each individual payer. You must check the scope of practice allowed for the Chiropractor in your State. Code 76140 is only used when the provider has been asked to consult (by another provider) on an x-ray made elsewhere. This is not the case here.
Medicare Policy: Coverage of chiropractic services is specifically limited to treatment by means of manual manipulation (i.e., by use of hands) of the spine for the purpose of correcting a subluxation. For the purpose of Medicare Chiropractic codes, a subluxation is defined as a motion segment in which alignment, movement integrity, and/or physiological function of the spine are altered, although contact between the joint surfaces remain intact. The patient must have a subluxation of the spine as demonstrated by x-ray or physical examination.

Keep in mind that x-rays are considered noncovered when billed by the chiropractor. No other diagnostic or therapeutic services furnished by a chiropractor or under his or her order is covered. This means if a chiropractor orders, takes or interprets x-rays or any other diagnostic test, the x-ray or diagnostic test can be used for claims processing purposes, but Medicare coverage and payment are not available for these services



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