Medical Billing Forum

General Category => General Questions => : catooch October 30, 2018, 02:40:44 PM

: Medicare visits
: catooch October 30, 2018, 02:40:44 PM

Hi.

I work for a chiropractor and he heard that in NY Medicare patients are only allowed a certain number of visits with a chiropractor.  Is this true?  If so we have not been notified and not once has a patient been denied for too many visits.  Will this come into play later when they review cases and ask for payments back? 

Thank You
Cathy

: Re: Medicare visits
: Michele October 31, 2018, 01:09:04 PM

I posted a response to this but for some reason it didn't show up!

Anyway, Medicare used to indicate that they would pay a specific number of visits depending on the secondary dx.  Certain dxs warranted 12 visits, others 24.  I don't believe they use that system any longer.  Now they just state "based on medical necessity"  The LCD from NGS is very helpful:

https://www.ngsmedicare.com/ngs/portal/ngsmedicare/newngs/home-lob/pages/medical-policy-center/mpc-search-detail/lcd%20for%20chiropractic%20services%20(l33613)/!ut/p/z1/pVJdb4IwFP0r2w8g9yII3WNFRQXkww-kL6ZiQTIBg4Zl-_WryzIT3WaW9aW5t6fnnJ5eYLACVvG2yPmpqCu-l3XCjLVOxwNVtdDx-6qJ1NEDHM19tLsmLCEZQjIr28UuhPgemslj_GFRhMk9gLTTaTzLy4Ed-GmnFFVWw6rKj6XYFilvhLTAPkguJjSfINWHvX4_DDS71_kE_KKSyGeYFwZiORZSyw286dBCDE2I20K8wKKqm1JmNDszHtJiCwnROhqKJ1UhW9NQdBSZsiGkqxipkaGhblAzBYxuFK6Ccr9ViC1vHS4Gkbx75K1I6_q5EGemdC94cyldvwdJwJvTg9yjgT32p7L9N4vXCcwjmYDjucvFmGho_zeBydUX3cxJbH_NFFPhUFavCtsYEXmZZ7u8pDSYKsmkfXPo4ztR9TeL/dz/d5/L2dBISEvZ0FBIS9nQSEh/?clearcookie=&savecookie=&LOB=Part%20B&REGION=