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