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Getting paid for 97112

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tg0306:
I bill for chiropractors in TN and FL and cannot get paid for 97112. BCBS denies the code as experimental and the other insurance companies state it is a non covered service. According to the Medicare NCCI policy, chiropractors can bill for this code. Has anyone been successful in getting paid for this?

DMK:
1. Be sure to bill with the 59 modifier to indicate it's a separate service.

2. Insurance companies have been carving out certain procedures.  You may want to call them and verify that 97112 is non-covered by the plan.  Also, be sure that what the doctor is doing is ACTUALLY neuromuscular re-education.  There are a lot of seminars teaching chiros to use certain codes for therapies and modalities that don't actually meet the criteria for the code.

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