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ChiroCare Coding and Documentation Seminar Highlights

, September 15, 2014

The Coding and Documentation seminar with Dr. Hamm on September 6, 2014, was a great success. Provider participation was excellent, and there were many questions and good discussions about specific concerns. If you couldn’t attend, below is a recap of the course, along with links to helpful information. 

The following are key items presented within the course

Common errors found during audits:

  • Insufficient documentation to support the use of 98941 and 98942 CMT Codes
    • Use of 98941 requires areas of subjective and objective findings related to 3-4 spinal regions
    • Use of 98942 requires 5 spinal regions
  • The ABN must:
    • Provide reason the service is not covered (i.e., Medicare does not cover maintenance)
    • Advise the beneficiary of financial responsibility and specifically list each service cost and the treatment time frame
  • The ChiroCare Non-covered Service Financial Disclosure Form must be used with all ChiroCare health plans, including the Medicare Advantage Plans
  • The maintenance care CMT code for all ChiroCare health plans including the Medicare Advantage Plans is S8890
  • Signature missing on SOAP notes — these must be signed by the provider
    • An electronic (typed) signature is not sufficient; it must include the signature image, initials, or be accompanied by a Signature Attestation or Signature Log
    • Guidance Documents:
    • Other missing chart information
    • Clinic or provider identification on each page and clinic form
    • Incomplete/illegible/incorrect patient identification or date of service diagnosis
    • Medical necessity of the services billed is not supported
    • Missing or incomplete information on date of service
    • Goals for treatment
    • Treatment plan

Helpful links from the ChiroCare website:

  1. Required chart information
  2. CMT billing

Other helpful links:

  1. MLN Matters:Advanced Beneficiary Notice of Noncoverage-ABN
  2. MLN Matters: GA Modifier
  3. Chiropractic Economics: Big Risks for Small Practices            
  4. OIG Report: Inappropriate Medicare Payments for Chiropractic Services