Medical Billing Forum

Billing => Billing => : PMBS October 20, 2011, 02:23:40 PM

: hspc code L0627 for Chiropractic
: PMBS October 20, 2011, 02:23:40 PM

Does anyone know if there is a special modifier that needs to be billed with this HSPC?  I billed this for an auto claim and the denial stated not reimbursable under Medicare/WC without appropriate CPT/HPCS code and modifier, if applicable.

Any help will be appreciated. 

Thanks

: Re: hspc code L0627 for Chiropractic
: DMK October 20, 2011, 03:43:48 PM

For Medicare claims it's not reimbursable for Chiropractic AT ALL, only 98940 and 98941 are allowed.  Each states' W/C has it's own codes for particular things, so you may need to check with your state.  If it's an auto claim, I'm not sure why that denial would even apply.  What DME is this for?

: Re: hspc code L0627 for Chiropractic
: PMBS October 20, 2011, 08:48:11 PM

The DME is for a Low Pro Electric Lumbar Sacral Orthosis Brace.  I am not sure why it got denied either because it is an auto claim for the state of FL.

Thanks

: Re: hspc code L0627 for Chiropractic
: Michele October 21, 2011, 10:38:01 AM

Not aware of a modifier for that situation.  Did you have an invoice attached?  I would call for clarification of the denial.