Are visits when a Chiropractor just uses a spinal decompression table billable to insurance? If so, what code is recommended?
There is a code to describe this service, it is S9090 - Vertebral axial decompression, per session. Some payers will cover this service and some do not. It should also be noted that some payers also allow 97012 to be used to report decompression. The best way to handle this is to review the payers policy before using 97012 because there have been reported cases where the provider had to return money for billing 97012 because the payer did not allow it for that service.
Coverage varies widely so there is no substitute for reviewing the individual payer policy to ensure that you are reporting the service properly.
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The OIG conducted a study dated June 2019 wherein they indicated that there were approximately $269 million in overpayments for polysomnography services for the period of 2014 through 2015. According to the OIG “These errors occurred because the CMS oversight of polysomnography services was insufficient to ensure that providers complied with Medicare requirements and to prevent payment of claims that didn’t meet those requirements.”
So what are those requirements?
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