Coding > Coding

chiro coding

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Trisha Reyes:
Hi Michele,

I am biling for a chiropractor, pt diagnosis are 722.10, 739.1, 739.2, and 719.55.  The cpt codes are 98941AT, GP97012, GP97110, and 97140AT.  I am billing to medicare (TX), what is the best way to bill the codes for maximum reimbursment for the Dr. ? My understanding is that the diagnosis codes should be:739.1, 722.10, 739.2, 719.55, and I think that the cpt codes may be ok the way they are? Is this correct?

Thank you,
Trisha

Michele:
The diagnoses should be fine.  The procedure codes also look ok, but the GP modifier goes after the cpt (I wasn't sure if that was just a typo).  Medicare will only reimburse the 98941 code.  That is all Medicare allows DC's to be reimbursed for.

Michele

Trisha Reyes:
what about the order of the diagnosis codes, should the order be different if they are of the same importance so medicare will allow a higher number of visits and is the primary diagnosis supposed to be specific diagnosis to be considered for payment ?

Thank you,
Trisha

Michele:
The order that you have them in is the right order.  You must have a 739.x code in the primary spot, and a valid 2ndary in the 2ndary spot.  The 2ndary dx is the one that determines the number of visits that will be allowed.

Michele

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