Author Topic: Billing Medicare secondary for Chiro  (Read 1230 times)

thatcuteblonde

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Billing Medicare secondary for Chiro
« on: June 03, 2009, 08:35:45 AM »
Hi guys, just a quick question! When billing Medicare as a secondary insurance for a chiropractic adjustment, is it necessary to bill with Medicare diagnosis codes? i.e. Sublaxation code, supporting dx code. (739.3, 722.52) or can you bill with just the 722.52? How would you handle it if the claim was already billed to the primary without the subluxation code and paid but denied by Medicare for not having these codes? Any suggestions?

Michele

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Re: Billing Medicare secondary for Chiro
« Reply #1 on: June 03, 2009, 10:14:32 PM »
If billing Medicare, whether primary or secondary, you need to have Medicare approved diagnoses.  When billing the secondary you should be using the same info that was billed to the primary.  Many times drs don't realize the importance of the order of the diagnoses and they just check them off.  You should make the dr aware of what is required so that he understands.  I'm not saying he should purposely put the diagnoses in an order so that he will get paid, I'm saying that he needs to understand the importance of putting the diagnoses in the order he wants them in.  In the case where the primary was already billed, technically you should submit a corrected claim to the primary insurance if indeed the diagnoses were not on the claim the way the dr intended them to be.  However, you may want to call the primary and ask them if they want a corrected claim.  If it doesn't affect payment they may not require it. 

Michele
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