How to Bill Chiropractic Diagnosis Codes For Medicare

Billing chiropractic solutions for the Medicare individual can seem to be difficult because of towards the quantity of policies which are particular towards the chiropractic occupation. on this write-up, we are going to target on the way to bill diagnosis codes effectively.

For chiropractic claims, seeing that Medicare only addresses spinal manipulation for that correction of the subluxation, we need to get started by acquiring a diagnosis of subluxation inside initially placement (primary) on the diagnosis codes.

On a HCFA declare kind, this really is Box 21D.

The only "11" primary diagnosis codes (ICD-9) that Medicare will accept for chiropractic claims are as follows:

-- 739.0 Nonallopathic lesions on the head area not elsewhere classified
-- 739.1 Nonallopathic lesions on the cervical area not elsewhere classified
-- 739.2 Nonallopathic lesions on the thoracic area not elsewhere classified
-- 739.3 Nonallopathic lesions on the lumbar area not elsewhere classified
-- 739.4 Nonallopathic lesions on the sacral area not elsewhere classified
-- 739.5 Nonallopathic lesions on the pelvic area not elsewhere classified

A phrase about terminology. Some chiropractors and code textbooks refer to those diagnoses as subluxations, segmental dysfunction or use related terms. For illustration, 739.1 could be outlined as cervical subluxation in some coding textbooks or reference products. irrespective of the way you "59" the diagnosis, these codes inside listing over would be the only key codes that use to chiropractic solutions inside Medicare method.

The use of those codes isn't going to ensure reimbursement, nevertheless, since the individual's health file need to document that CMS protection standards (medical necessity) has long been met.

A massive caution right here, however. Failing to make use of these codes inside key (1st position) diagnosis will essentially ensure a DENIAL!

So, make sure to make use of the proper diagnosis codes when billing Medicare for chiropractic claims therefore you have taken the initially stage in acquiring your declare compensated!