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Q: Our Medicare contractor is auditing claims with 98942. Do you have any suggestions for a template for documentation to warrant the use of 98942?


Q: Our Medicare contractor is auditing claims with 98942. Do you have any suggestions for a template for documentation to warrant the use of 98942?

Date Posted: Thursday, November 05, 2015

 

A: Using the code 98942 indicates that you determined that it was medically necessary to adjust all 5 of the spinal regions. You documentation needs to reflect that fact, including that the patient had complaints in all five regions. The 98942 is a favorite target of auditors because many providers adjust full spine without establishing medical necessity for all five regions. Essentially, each area must have a patient complaint, relevant objective findings, a clear plan for resolution, and demonstrable progress.

www.findacode.com


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