The following is an excerpt from the newly revised "Common Procedure Codes" section in the 2016 ChiroCode DeskBook. In this chapter we have provided an explanation, coding tips, suggested diagnoses, and modifier guidance for all your top CPT codes. If you find this sample helpful, make sure you order your own copy of the 2016 DeskBook. Special pricing is still available until 12/31/2015.
The force used to create a degree of tension of soft tissues and/or to allow for separation between joint surfaces. The degree of traction is controlled through the amount of force (pounds) allowed, duration (time), and angle of pull (degrees) using mechanical means. Terms often used in describing pelvic/cervical traction are intermittent or static (describing the length of time traction is applied), or auto traction (use of the body’s own weight to create the force).
This code may only be billed once per patient, per encounter, regardless of time or number of areas treated. Roller table type traction normally meets the requirement of auto-traction, the use of the body’s own weight to create the force; yet payers may have specific coverage guidelines.
Unless clinically indicated, routine and/or extended use of roller tables for patient care should be avoided.
Some payers may deny payment if the device used is not FDA cleared. Review payer policy guidelines for this information.
Vertebral axial decompression, per session, should be reported with code S9090 unless the payer policy indicates that 97012 is an acceptable or preferred code to submit for decompression procedures.
“Flexion-distraction” technique is generally considered a Chiropractic Manipulative Treatment and should be reported with codes 98940-98942.
Adhesions, stiffness, arthritis, and compression.
Consider ICD-10 codes from the following groups:
When billed on the same visit as 97012, it may be necessary to add an appropriate modifier to:
Why is HIPAA So Important?
Some may think that what they do to protect patient information may be a bit extreme. Others in specialty medical fields and research understand its importance a little more. Most of that importance lies in the information being protected. Every patient has a unique set of ...
There are a few payers that have joined with CMS in discontinuing payment for consultation codes. Most recently, Cigna stated that, as of October 19, 2019, they will implement a new policy to deny the following consultation codes: 99241, 99242, 99243, 99244, 99245, 99251, 99252, 99253, 99254 and 99255.
United Healthcare announced they ...
This ruling impacts what providers and suppliers are required to disclose to be considered eligible to participate in Medicare, Medicaid, and Children's Health Insurance Program (CHIP). The original proposed rule came out in 2016 and this final rule will go into effect on November 4, 2019.
There have been known problems ...
When federal employees sustain work-related injuries, it does not go through state workers compensation insurance. You must be an enrolled provider to provide services or supplies. The following are some recommended links for additional information about this program.
Division of Federal Employees' Compensation (DFEC) website
Division of Federal Employees' Compensation (DFEC) provider ...
It’s that time of year for offices to get ready for the ICD-10-CM code revisions. As part of that process, it’s also good to know what is going on with the ICD-10-CM Official Guidelines for Coding and Reporting. In the examples listed below, strikeout text is deleted and highlighted text ...
Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99)
A small revision in the description changed[STEC] to (STEC) for B96.21, B96.22, B96.23. Remember, in the instructional guidelines, ( ) parentheses enclose supplementary words not included in the description (or not) and [ ] brackets enclose synonyms, alternative wording, or explanatory phrases.
Chapter 2: ...