Medical Billing Forum
Billing => Billing => : ACCUTRANS INC April 29, 2008, 01:20:03 PM
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Does anyone have information regarding supplmental HCFA/CMS1500 use for additional diagnoses, other than the four present on a hard copy CMS1500 with specific relation to Personal Injury/MedPay claims in a chiropractic office?
I have the supplmental HCFA form and understand its use; however, I have an issue with the chiropractor "adding" additional diagnosis (sometimes up to 12!) under the direction of an attorney in order to max out the claim when processed through Collosus by the adjustor. These diagnoses are not commonly used by a DC, and I am not happy about the entire scenario. How could each visit have 12 treating diagnoses?
Any thoughts/past experience greatly appreciated!
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Hi,
If a Dr needs to report more than 4 diagnoses (and the CMS only allows for 4) then they would need to attach a sheet indicating the additional diagnoses (5 and on). But the Dr should only be reporting the diagnosis that relate to the service that he/she is providing. I agree that an attorney should not be dictating to the Dr what dx's to put on the claim. Sometimes attorneys will make suggestions to providers to indicate that a certain problem needs to be addressed and if it is appropriate the dr can follow those suggestions. ;)
I hope that helps!
Michele
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Michelle,
I wonder why also a patient will have more than 4 diagnosis on the same visit because that's too many??
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Most patients do not have more than 4, but there are some severe cases that do. It's not that uncommon. If a person has a 'bad back' it's not too hard to come up with more than 4 diagnoses, especially if the dr is manipulating 5 or more regions. We bill for a DO who regularly has more than 4 diagnoses.
Michele