Q/A: Can I Put the DC’s NPI in Item Number 24J for Massage Services?

July 8th, 2019 - Wyn Staheli, Director of Research
Categories:   Chiropractic   Billing   Compliance  
0 Votes - Sign in to vote or comment.

Question:

Are there scenarios in which it is acceptable to put the DC's NPI in box 24j for massage services? 

Answer:

While the answer to this is yes, it is essential to understand that there are very limited scenarios. In most cases, Item Number 24J is only for the NPI of the individual who performed the service. 

So when can another provider enter their NPI in this field? Medicare allows for the supervising provider’s NPI to be listed in 24J when it is “incident to”.  We talked to many colleagues about this and even though we all agreed that “incident to” rules don’t really apply to chiropractors, there are some payers which may allow you to use the supervising provider’s NPI. In fact, some even require that the chiro’s NPI be reported in 24J when they are supervising a licensed massage therapist (LMT).  This is the case with Highmark BlueCross in Pennsylvania.

It may not even matter if the patient is not seen by the DC on the same day. I know of one payer policy which will only pay for massage if it is on a different day than a CMT. Therefore, it comes down to payer policy and individual payer contracts. Carefully review your payer contracts and make sure you are doing it in accordance with their policy.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

Impact of 2021 Proposed Medicare Fee Schedule on Chiropractic Offices
August 7th, 2020 - Wyn Staheli, Director of Research
On August 3, 2020, the proposed Medicare Physician Fee Schedule for 2021 was released. This 1,355 page document includes some sweeping changes to the Medicare program. There are a few items in particular which should be noted by chiropractic offices.
Coding with PCS When There is No Code
August 5th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
ICD-10-PCS covers ALMOST everything! But not quite! What if a body system does not contain a body part for toes or fingers? What about an elbow? When it does not cover what you are looking for, where do you turn?  To the guidelines, of course! There are ICD-10-PCS guidelines just as ...
To Our Codapedia Friends!
July 30th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
Codapedia friends, come and join us at Find-A-Code - a core product of innoviHealth! The information found on Codapedia comes from our sister company, Find-A-Code. If you do not already have a subscription with the greatest online coding encyclopedia, call us and get signed up today. We are offering a ...
OIG Report Highlights Need to Understand Guidelines
July 28th, 2020 - Wyn Staheli, Director of Research
A new OIG report once again highlights the necessity for organizations to fully understand requirements for reporting services and having proper documentation. The types of problems addressed in this report are ongoing issues for multiple types of services and specialties and for many different payers.
Office of Inspector General Says Medicare Advantage Organizations are Denying Services Inappropriately
July 21st, 2020 - Aimee Wilcox
We attended the recent virtual RISE National Conference and had the opportunity to listen to presenters share their knowledge about risk adjustment and HCC reporting and data validation. Among the presenters were representatives from the Office of Inspector General (OIG), who presented findings from encounter data from 2012-2016. They began ...
Use the Correct Diagnosis Codes and Revenue Codes to Get Paid for PAD Rehab
July 15th, 2020 - Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
The initial treatment in rehabilitation for patients suffering from Intermittent Claudication (IC) is Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD).  Rehabilitation using SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest.   When reporting 93668 for peripheral arterial disease rehabilitation the following ...
New Name Same Great Product! "HCC Plus"
July 14th, 2020 - Find-A-Code
Hello HCC Customers! We have made a change in name only to our HCC subscription. The new subscription is now called “HCC Plus”. Keep in mind there have been no changes to the product. Using your subscription along with the risk adjustment calculator will ensure you stay current with...



Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2020 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association