Billing > Facility Billing
Chiropractic coding
mauletta:
Thank you so much Dina I really appreciate your help!
Maria
Pay_My_Claims:
--- Quote from: mauletta on March 31, 2010, 12:37:06 PM ---The problem is the dr. isn't sure what code to use for the diagnosis. Subluxation of the cervical, thoracic and sacrum region
--- End quote ---
dr needs to go back to school
Alice Scott:
I love you Charlene!
DMK:
It is unfortunate that the doctor doesn't know which diagnosis code to use. The doctor SHOULD be able to use a correct code easily. But there's a bit of a "conspiracy" with the insurance companies, Medicare in particular. In some states they will pay the 739.X Segmental Dysfunction Codes, sometimes pay the 839.X Subluxation codes. In California, Medicare used Subluxation codes until 2009 then switched to segmental dysfunction codes. Both are good codes, describing a segment of the spine that is not moving properly. It's not apples and oranges, it's Red Delicious and Fuji!
In chiropractic there's a "school of thought" called a Subluxation based practice. It's where the philosophy is that "subluxations" cause all disease and ill health. If the doctor corrects the subluxation, he "cures" the disease. The problem is, the medical definition of subluxation is dislocation. The spinal bones may be out of alignment but they're rarely medically dislocated. But if your doctor is a subluxation based practice, he may always want to bill 839.X codes. And he might not get paid.
It's a tough one, unfortunately we sometimes have to figure out how the insurance company WANTS it coded in order to get paid for our services. Screwy huh? We've fought for years to be treated like other specialists, but since there are still so many wacky chiropractors out there it's an uphill battle.
Your Chiro may want to go to a billing seminar so that he understand how to code correctly so that his biller can get his claims processed correctly and quickly. Since you're a biller, not a coder, it makes it tough for you to process his "garbage" and turn it into cash!
Dina
Pay_My_Claims:
--- Quote from: Alice Scott on April 01, 2010, 08:45:45 AM ---I love you Charlene!
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(( hug ))
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