Medical Billing Forum

Coding => Coding => Topic started by: dfranklin on June 19, 2009, 01:38:33 PM

Title: Coding for Chiro /WC
Post by: dfranklin on June 19, 2009, 01:38:33 PM
When I file a claim for my chiro to WC we get reimbursed about 50% of what was billed.  For Example here is the last one I filed and recieved:
98940 Charge = $60 Allowance = $36.22
98943 Charge = $60 Allowance = $25.42
97122 Charge = $60 Allowance = $0
97014 Charge = $30 Allowance = $9.23

Is there something I should be doing differently or is this the norm?  I just want to make sure I am doing what I can for my provider.  Thanks!
Title: Re: Coding for Chiro /WC
Post by: Michele on June 20, 2009, 07:18:50 PM
You need to check the WC rules for your state.  In NY a DC can't bill the 9894* codes.  They have to bill 99203 or 99213 and they are allowed a specific $$ amount no matter what they do.  Modalities are not allowed separate.  I'm not sure what state you are in but that may be why your reimbursement is only 50%.