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Chiropractor Sends Notes/Instructions after Seminar

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dfranklin:
Man...how did you learn all of this?  Where can I go to learn this stuff? It seems like it is all trial and error and On the Job Training.  I can't find anywhere to teach you this kind of details.

WHich is why i really appreciate your help.

When you put the levels (C1-3, T8 etc) in 19 and the DOI in 14 do you have to keep putting them on each claim until released or new injury? Or does it stay on record with them (carrier/medicare) after you report it initially?


I guess I have to have them send chart notes so I know what the levels are becuase there is nowhere on the superbill for this.

Thanks!

DMK:
All I know is Chiropractic billing.  I went to several HJ Ross seminars, but learned that they don't have ALL the answers.  Some was trial and error.  When Medicare changed from NHIC to Palmetto for processing I spent MANY hours on the CMS site trying to find answers to my questions.  Luckily I only do my office's billing, so I am definitely no expert.  This site has been a great help to me, and I'm glad to pass along anything I may have learned to the next person to make their lives easier!

I, personally leave the DOI (box 14) and the levels (line 19) the same until the patient has a new complaint.  If you are able to see when that patient was last treated, you can see when there is a gap in care and see when they might need a new DOI or DX.  Bear in mind, this is Medicare, the patient's are elderly, they can come for 2 visits for one thing, then have a fall and have a whole new problem. 

It's really important that the Dr. give you the best information so that he gets paid at the right level, and if he ever gets audited, that the claim reflects the correct information with the notes.  Also, if you ever get an audit, make sure the notes are transcribed and SIGNED "reviewed by Dr. Soandso."

Many DC's in our area were only billing a 1-2 (98940) because they could never get a 3-4 paid.  You have to have the dx's to match what you're billing for. 

Also, if your Dr. treats Work Comp patients, if it's a one area injury, you can't bill a 3-4!  Even if he adjusts 3-4 areas.  (Activator docs try to do the 5 area code, it won't fly if your dx is for Cervical only!)

I'm glad I could help.  I hope it's good karma!

Michele:
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

DMK:
No.  I've never put the word "none" on a claim.  Man, your Medicare processor is tough!

I finally HAD to file and get paid by Medicare electronically.  I thought it would be a nightmare, but it's very timely.  You can count the days on the calendar, then check the clearing house for the EOB, and "poof" it's in the bank.  The set up was a NIGHTMARE though.  I still have bad dreams about form 855!

Michele:
We have to put none on all Medicare claims, not just my area.  We've done NY, FL, CA, PA, etc.  That's weird! 

Michele

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