Medical Billing Forum

Coding => Coding => Topic started by: dfranklin on September 21, 2009, 05:07:07 PM

Title: 97112 Investigations
Post by: dfranklin on September 21, 2009, 05:07:07 PM
One of my chiropractors asked me about this today.  He said he has heard in billing seminars that they are doing investigations on and cracking down on people using 97112 that it should be used for stroke patients only.  Chiropractors use this a lot is this correct? Have you heard anything about this?  Should chiros be using  a different code for procedures with Interactive Metrodome?
Title: Re: 97112 Investigations
Post by: Steve Verno CMBS, CEMCS on September 22, 2009, 06:48:08 AM
Question,

Did the provider obtain any reference to the alleged investigations???

if not, maybe there arent any investigations.  I am a speaker at many billing seminars.  When I present a seminar, I provide the reference to my subject.  If there is NO reference provided, how do we know what is presented is true or is it an ego trip where the speaker is trying to sound credible byere presenting something that makes it look like they are the first to announce something.  But, with reference, then you have credibility. Without reference, it may be nothing more than BS. leavin you to spend hours and asking others to spend hours seein if this story is true.

For example, if I said, in 2010, Medicare proposes the elimination of payment for consultation codes.
Sounds real.  But so far there is no reference to what I just said.  To provide legitimacy to my name and background, here is my reference: http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3469&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1,+2,+3,+4,+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date. 

IN January 2003, the OIG published a study called Comparing To Private Medicare Physician Payments Payers.  CPT 97112 is listed in Appendix D of that study.  http://oig.hhs.gov/oei/reports/oei-06-00-00570.pdf


Is this code under investigation?  I dont know.  Im not a private researcher and I cannot provide credence to what someone heard at a seminar without any reference to that thing that was heard, no will i devote anytime to reearching what someone heard.  Sorry
Title: Re: 97112 Investigations
Post by: Michele on September 22, 2009, 09:17:39 AM
I always hate when one of my docs says "I was at a seminar and they told me....."  Who put on the seminar?  Who was the speaker?  etc. etc. etc.  It is very important that they make sure the seminar is legitimate and that the speakers know what they are talking about.  I don't know too many PT's that don't use the 97112 and it's not for stroke patients.  I know DC's that use it (although they don't usually get paid) and some DO's that use it.  Again, not usually for stroke patients. 

Michele
Title: Re: 97112 Investigations
Post by: dfranklin on September 23, 2009, 12:10:45 AM
Thanks for the replies...now I have a good response to provide when this type of thing comes up again.  Thanks for the feedback on the procedure too.  I will inform my provider.  Thanks again!