Billing > Billing
Chiropractor Sends Notes/Instructions after Seminar
Pay_My_Claims:
Michelle, I had to remove it on medicare claims as well here.
Michele:
You mean you used to use it, but now you don't?
dfranklin:
I am confused when it comes to reporting the DOI, First Treatment Date....
This is for a chiro. The DOI (Date of Injury) is related to the current DX codes is that correct? So if the Dr updates or provides new DX codes then the DOI gets updated to the date of the new DX codes?
Also do the levels only change when the DX changes (I shouldn't see these change unless the Dr provides new DX codes, correc)?
What about date of first treatment or First Consult? Does this matter or get reported to the carrier? I don't know what line this would go on, but my software asks for it and also I saw it requested in my software by Medicare. My software support said that it may not be on the form but it could get transmitted electronically to them. So is the First TX or Consult date going to be the same as the DOI and reflect the first date the DX codes were reported OR is it the first date EVER that this patient has been seen by the doctor?
Trying to get a good understanding of all these dates etc.
Thanks again for your help!
DMK:
This is Medicare right?
I can only relate what has worked for me. When the patient presents with something new, or hasn't been in for awhile then all your dates should be updated to the current DOI. The diagnosis codes could be the same if it's just a flare up of the thing that usually bothers them, but the dates should be updated because it's basically like a new injury. The vertebra levels the doctor treated on this new DOI should be in box 19. (They could be relatively the same as most people tend to hurt in the same areas, since they tend to do the same things in their lives).
This will begin, basically, a new treatment plan. So the number of visits allowed (by Medicare for a certain condition) will start over.
For other kinds of insurance the vertebra levels don't need to be reported. But your DOI and current diagnosis should reflect each plan of treatment as most insurance companies DON'T pay for supportive care. Any time there's a change in the patient's condition or a significant event that has triggered this new need for care (fall, trip, slept wrong, dog pulled them) there should be a new DOI. This helps avoid red flags from the insurance company.
EVEN IF the patient is one who gets fairly regular care, keep an eye on the DOI and the dates of service so everything is current. Chiros in particular get kind of set in what they're doing and don't always update their DX's and DOI's. If a file looks stale, you might want to ask the doc.
Dina
MBP:
--- Quote from: Michele on January 19, 2010, 10:44:46 AM ---I only have one comment/question. When we submit Medicare claims, whether electronic or on paper, and whether Medicare is prime or secondary, if we don't have the word "none" in the group number (box 11) the claim is denied. Haven't you had that problem DMK?
Michele
--- End quote ---
Michele, I bill for MI - same here - without "none" the claim is rejected.
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