Chiropractor coding

[kmoore]

Hello,

I have a Dr that is doing decompression on a patient and also using cold lazer therapy.  He is using the code for manipulation for the decompression but if he is also doing an adjustment he wants to use the same manipulation code for that one also.  Can he use the same manipulation code for the same visit twice and just point them to two different dx codes? And can he also use the infared code for the cold lazer therapy?  This is for a UHC patient.

You guys are a huge help,  thanks in advance for all the help you give, I'd be lost without this forum.

Thanks
Kim

[Michele]

Hi,
   
    You can't bill for two manipulations on the same day.  The codes specify the regions, so if he were to bill for 98941 two times, they would say you should have coded it as a 98942, and possibly a 98943. 

There is not a specific cpt code for decompression therapy yet.  Many recommend billing it using S9090 or 97039 or 97139 or 97799.  I have also seen it coded as 97012.  Most insurances do not cover it since they still consider it experimental. 

The same is true for the cold laser therapy.  I have seen it billed as 97112 or 97140 but I haven't had any direct experience.

Hope that helps!

Michele

[kmoore]

Michele,

So can he bill for two 97012 in the same day once for intersegmental traction (which is the accepted code) and then again for decompression?

Thanks,

Kim

[Michele]

You could try that, indicating the different diagnosis.  Or you could bill it with a 2 in the units, and double price.

Michele

[kmoore]

Michele,

I also have a patient that he is using dx code 847.0,  what modifier do I need with that one on the CPT Codes being used of 98940, 97012, 97014, 97026, & 97010.  I have the chiropractic Billing Made Easy manual from your website but not sure still on modifiers yet.

Thanks
Kim

[Michele]

If you are not billing Medicare (which I'm assuming you're not based on the diagnosis) then you don't need any modifiers on those codes. 

Thanks for the kind words.  That's why we do this. 

Michele

[kmoore]

Michele,

When I hit submit on my software it is saying that Condition Related to Code A,O or E required if primary ICD-9 is 800.00 - 995.0.

Do you think this is a glitch in the software or something?

Thanks

Kim

[Michele]

Because the diangosis indicates that there may have been an accident involved it is asking you if it is related to an (A)ccident, (E)mployment, or (O)ther.  I'm not sure what software you have.  It shouldn't be a requirement that you fill in that field since not all injuries are the result of an accident.  If you can't get around it I would indicate other, unless it was workers comp or no fault.

Michele

[kmoore]

Michele,

On this 847.0 dx code which cpt code do I need to apply that modifier O to just the manipulation code of 98940 or all the cpt codes? and what if there are other modifiers on the cpt codes? and if I need just the modifier on code 98940 then do I just point to the one dx code or all of them?

help

Thanks
Kim

[Michele]

I'm not sure if you had a typo, or if you are asking if you need to put a modifier "O" on the line.  I've never heard of a modifier "O". 

For Chiropractors, the modifier usually needed is the "AT" modifier for Medicare.  Medicare only allows the manipulation codes - 98940-98942, so the AT modifier must be on those.  We put the AT modifier on all charges billed to Medicare but it's mostly out of consistency. It doesn't have to be on the charges that Medicare doesn't allow, since they are not going to be paid anyway. 

Sometimes the "59" modifier is used on modalities to indicate separate procedure, but that is about all I usually see. 

As far as the diagnosis pointers, you should be pointing all diagnoses that are appropriate to each procedure.  The modifier wouldn't affect that. 

Let me know if you meant something else.

Michele