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:
To determine the dosage, size, doses per package and how many billing units are in each package, refer to the NDC number.
Take a look at the following
J1071 - Injection, testosterone cypionate, 1mg
For example; using NCD # 0009-0085-10 there are 10 doses of 100 mL
(100 mg/mL = 1 mL and there are ...
As we begin returning back to work, we will all face a new normal. The COVID-19 pandemic has changed the face of business. While it has certainly been a challenge to keep up with the ever-changing regulations (that’s likely to continue for a little longer), exciting new opportunities have also been created, such as the expansion of telemedicine. There’s also the maze of government funding that needs to be navigated and an increased awareness of OSHA standards to implement.
The CDC has released additional information and coding guidance for reporting encounters related to the 2019 health care encounters and deaths related to e-cigarette, or vaping, product use associated lung injury (EVALI).
The update offers coding scenarios for general guidance, poisoning and toxicity, substance abuse and signs and symptoms.
ICD-10-CM Official Coding Guidelines - ...
On April 30, 2020, CMS announced additional sweeping changes to meet the challenges of providing adequate healthcare during this pandemic. These changes expand the March 31st changes. The article covers some of the key changes. See the official announcement in the references below.
Risk adjustment is simply a way of making sure that there are sufficient funds to adequately take care of the healthcare needs of a certain population. It’s a predictive modeling methodology based on the diagnoses of the individuals in that population. As payers move to value based models, they heavily rely on risk adjustment to ensure proper funding.
All healthcare providers who are currently participating in the MIPS portion of Medicare’s Quality Payment Program may want to participate in the new COVID-19 Clinical Trials improvement activity. Read more about it here.
With all the new laboratory test codes that have been added due to the current public health emergency (PHE), there are a few additional guidelines CMS has released about collecting samples to perform the testing. Please keep in mind that these guidelines are by CMS and may or may not apply to other commercial payer policies.