Medical Billing Forum

Coding => Coding => : tg0306 January 13, 2012, 08:38:15 AM

: Getting paid for 97112
: tg0306 January 13, 2012, 08:38:15 AM

I bill for chiropractors in TN and FL and cannot get paid for 97112. BCBS denies the code as experimental and the other insurance companies state it is a non covered service. According to the Medicare NCCI policy, chiropractors can bill for this code. Has anyone been successful in getting paid for this?

: Re: Getting paid for 97112
: DMK January 13, 2012, 01:12:28 PM

1. Be sure to bill with the 59 modifier to indicate it's a separate service.

2. Insurance companies have been carving out certain procedures.  You may want to call them and verify that 97112 is non-covered by the plan.  Also, be sure that what the doctor is doing is ACTUALLY neuromuscular re-education.  There are a lot of seminars teaching chiros to use certain codes for therapies and modalities that don't actually meet the criteria for the code.