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Coding for Chiro /WC

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dfranklin:
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!

Michele:
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%.

Michele

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