Medical Billing Coding - Chiropractic billing, cpt, codes
medical billing and coding forum

BC Advantage Magazine


Billing-Coding.com

(FORUM HOME)

General Medical Billing Forum

New Topic  |  Search

Thread Topic: Chiropractic billing
Topic Originator: Lou
Post Date February 24, 2006 @ 3:33 PM
Chiropractic billing


Lou
February 24, 2006 @ 3:33 PM Reply  |  Email Friend   |  |Print  |  Top

Wondering if anyone can advise regarding chiropractic billing.  Is it significantly differernt from any other specialty billing?

CHERI
February 27, 2006 @ 7:48 AM Reply  |  Email Friend   |  |Print  |  Top

It's pretty easy billing. It is how I got started.  They use only a handful of codes.

Medicare requires they use a specific code set or it is not covered and only covers the manipulation, no therapies.

Some chiros do a lot of auto accidents and work comp which can be a little different inthe way you go about it, but often quite lucrative.

Cheri

Tammy Harlan
February 28, 2006 @ 9:53 AM Reply  |  Email Friend   |  |Print  |  Top

Hi Lou,

I specialized in chiropractic billing for many years.  In my opinion, it's a wonderful specialty for several reasons.  As was mentioned, there are not a lot of codes to work and it doesn't take long to become familiar with the procedures performed and the usual inquiries from carriers, etc.  Also, because chiropractors tend to stay in touch with other chiro's they went to school with, I received many word-of-mouth referrals when one of my clients would speak about their billing company.  If you can be really good in one area specialty, chances are good that you will be sought out by new and prospective clients.

Tammy Harlan
Medical Billing Course.com
www.medicalbillingcourse.com

Renato Pereira
June 27, 2006 @ 2:49 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Tammy,

    I am starting with chiropratic specialty can u send me more information on how to proceed and if u do have a write that would be a very useful source for my venture.

Can you mail the inform to rperiera@acetera.com
www.acetera.com

Renato Pereira
June 27, 2006 @ 2:52 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Cheri,

    Sorry i missed out your name can you send me a write which will be very helpful.

can you mail me at rperiera@acetera.com
www.acetera.com

mom4td
June 27, 2006 @ 4:09 PM Reply  |  Email Friend   |  |Print  |  Top

I am not sure what you mean by a "write".  Your question is vague. What type of information exactly are you looking for?  

It seems that you are employed by a large outsourcing company, and are wanting to strike out on your own?

Renato Pereira
June 27, 2006 @ 4:19 PM Reply  |  Email Friend   |  |Print  |  Top

Hi all,

       Yes we are servicing the clients in Virginia and we just had a contract signed on chiropratic.

Write up in the sense if u can send me what are issues and what codes will be denied by the carrier and paid by the carrier so that i can be aware and do the needful (Insurance based).

is there any specific modiiers to be billed?

Can you mail me at rperiera@acetera.com
www.acetera.com

mom4td
June 27, 2006 @ 5:01 PM Reply  |  Email Friend   |  |Print  |  Top

It seems to me that you need to ask your employer to train you to do your job not us.

Leah
June 27, 2006 @ 5:31 PM Reply  |  Email Friend   |  |Print  |  Top

I agree with Cheri - these are the things you should be exploring BEFORE you sign a contract.  If you don't feel  you can find your own resources (of which there are plenty - but of course you would likely have to PAY for them and I think that's the crux of the matter) or learn on the job, you shouldn't be soliciting those types of providers.

Renato Pereira
June 27, 2006 @ 5:55 PM Reply  |  Email Friend   |  |Print  |  Top

hi ,

     I have 9+ yrs of exp and i know all the basic from entry to follow-up but i was not lucky enough to get exposure to chiropractic specialty so i just wanted to know how tough and what kind of encounters of denials will i come across.

It was just a request from my side

Renato Pereira

Leah
June 27, 2006 @ 7:37 PM Reply  |  Email Friend   |  |Print  |  Top

No, in your own words, you wanted "a write" - you wanted someone to write down "... if u can send me what are issues and what codes will be denied by the carrier and paid by the carrier so that i can be aware and do the needful (Insurance based)."  You wanted someone to write your policies/protocols manual, or at least the bulk of it.

In the first place, this is an IMPOSSIBLE order to place.  No one can predict how you or your client are going to conduct your business, therefore it is impossible to predict what kind of denials you get.  I would venture a guess that 90% of the denials are due to PROVIDER and/or BILLING error, therefore there is no way anyone can give "a write" telling you what kinds of denials you are going to get.  Secondly, anyone with 9 years of experience knows how to determine, if it can even be determined, what codes will and will not be paid by any given provider.  Anyone with 9 years of experience knows how to determine what modifiers are needed and when they are needed.  The resources are out there, but you have to (1) pay for them and then (2) read them.  That's how those of us who do our jobs well did it.  Of course, some of them are free and even posted on the internet, but I would imagine that if your spelling while your using Google is as bad as when you're posting,  you are probably running into problems.  Well, that's one of the pitfalls of the global market.  

When someone comes into a billing forum and says "oh my gosh, my colleague just got fired and now I'm going to have to do the billing for the surgeon in our group!  I've never done surgery!  Give me the basics so I don't make a complete mess of it!" I will bend over backwards to help, because that person has been put into a bind through no fault of their own, and they're asking for the basics to get them through until, and as, they learn on their own.

I also don't mind asking questions of the sort like "I'm really confused about the difference between code XXXX1 and code XXXX2.  I'm reading and rereading the CPT descriptions but it just makes my head spin.  Can someone put it to me in different words so I can see it clearer?"  

I also am aware that no one knows everything, and since the resources are so vast, sometimes it's easy to lose your way or not be able to find the answer to that one question - such as the question about observation codes elsewhere on the board today.

But when someone SOLICITS a specialty they know nothing about, then expects some strangers on a billing board to give them "a write"? This is like the dumb or lazy kid stealing the industrious, smart kid's homework and then basking in the glory when the teacher marks their paper with a 100%.  Only so they can impress their new client ?  No sir, those folks get no support from me.  And I support anyone who refuses to play along.

Okay, okay, perhaps it wasn't YOU that did the soliciting - maybe you are just a little biller in a big, big company who's only trying to do his job.  Well, then, I would reiterate what Cheri said - you need to ask your employer to train you.

Renato Pereira
August 9, 2006 @ 2:48 PM Reply  |  Email Friend   |  |Print  |  Top

hi all,

      I received a rejection from medicare on procedure code 97014

stating it as invalid. I have asked the EDI department for clarification ,

can anyone suggest for an alternate code.

Thanks
Renato Pereira

Renato Pereira
August 9, 2006 @ 2:48 PM Reply  |  Email Friend   |  |Print  |  Top

hi all,

      I received a rejection from medicare on procedure code 97014

stating it as invalid. I have asked the EDI department for clarification ,

can anyone suggest me for an alternate code.

Thanks
Renato Pereira

Ms Seay
August 9, 2006 @ 3:52 PM Reply  |  Email Friend   |  |Print  |  Top

Why don't you start research for yourself and contact Medicare. Any experience biller would know that a "invalid" rejection code from Medicare could mean several things. Stop asking others to do your work for you.

Renato Pereira
August 9, 2006 @ 5:19 PM Reply  |  Email Friend   |  |Print  |  Top

Hi All,

Electrical Stimulation (Unattended)
Procedure code 97014 Application of a modality to one or more areas; electrical stimulation (unattended) has been designated by CMS as not covered for Medicare as of January 1, 2003. This code has been replaced by G0283 - Electrical stimulation unattended to one or more areas for indication(s) other than wound care, as part of a therapy plan of care.

Services which were submitted for non-wound care electrical stimulation under 97014 and rejected due to an invalid code may be submitted as new claims using G0283.

Remove 97014  E Stimulated unattended (Not payable by medicare)(Replaced by G0283)

Issue solved thank you

Ms Seay
August 9, 2006 @ 5:29 PM Reply  |  Email Friend   |  |Print  |  Top

Make a difference when you research for youself huh! Great job!

Renato Pereira
August 25, 2006 @ 9:45 AM Reply  |  Email Friend   |  |Print  |  Top

Hi All,

       Recvd a denial from medicare for P.code -99202 that office visit for new patient will not be covered under chiro and we have used modifier GY:GA(GY- No medicare benefit & GA - Waiver on file) on the claim.

Has anyone recvd payment do let us know ?

Thanks
Renato Pereira

Julie
August 26, 2006 @ 11:33 AM Reply  |  Email Friend   |  |Print  |  Top

Hi Cheri,

I have 8 years experience with Chiro billing and want to start my own business.  Should I get certification as a biller/coder?

Thanks

Julie
August 26, 2006 @ 1:11 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Tammy,

I went to the web site noted medicalbilling.com.  I take it that you are either affiliated with or familiar with the course.  I have 8 years billing experience in a chiropractic office and I am interesed in venturing out on my own.  I want to do this right.  Is having certification as a medical biller necessary or recommended when starting your own billing service?  I want to be able to offer quality service to my clients.

Thanks for your time

Julie

Cheri
August 28, 2006 @ 11:43 AM Reply  |  Email Friend   |  |Print  |  Top

Hi Julie:

I am just now taking my exam for certification after 7 years in business.  So it is not absolutely necessary. I would say especially not if you are staying with chiro billing.  

I am in a situatiion where I have the time to do it now and need to start marketing again, so I figured it couldn't hurt. Especially if I want to venture out to other specialites.

Tammy's course is a great one if you want to take a billing course. She has weeded out the non-essential stuff and gets down to the nitty gritty of real billing!

Cheri
August 28, 2006 @ 11:48 AM Reply  |  Email Friend   |  |Print  |  Top

Renato....I do not understand your question. If you are using the GY and GA modifiers then you already know that it is not covered by Medicare.

So why would you expect payment?  Medicare only covers the manipulation and nothing else...nada. (Except for those states where they are doing the pilot on chiros billing therapy codes)

Cheri

Renato Pereira
August 28, 2006 @ 12:22 PM Reply  |  Email Friend   |  |Print  |  Top

hi cheri,

          Thank you for clearing my doubt.

Thanks
Renato Pereira

Tammy Harlan
August 31, 2006 @ 11:56 PM Reply  |  Email Friend   |  |Print  |  Top

Julie,

I'm going to reiterate what Cheri said.  Certification in medical billing is simply not a requirement.  Does it help?  Well, it depends.  Since certification in medical billing is not a requirement, your certificate is actually only as good as the course you chose to take.

There are some entities who try to lead the public to believe that they provide "nationally recognized medical billing certification"...  when, no such thing exists.  

We feel that we provide the very best course available for medical billing.  We do provide certification...  in our course work...  and we do not mislead people to believe that it is "nationally recognized" when this doesn't even exist.

I think our course stands on merit.  We don't mislead people, our students love the course and we have many success stories to report.  We must be doing something right.  Check us out.

Tammy Harlan
Medical Billing Course, LLC
www.medicalbillingcourse.com

Bianca
September 7, 2006 @ 9:39 AM Reply  |  Email Friend   |  |Print  |  Top

Renato, these replies were pretty harsh.  Please send me your questions directly and I will gladly help you in any way I can.  I have been doing CHIRO billing for over 10 yrs and I look forward to helping you- if I can.

Renato Pereira
September 7, 2006 @ 1:28 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Bianca,

       How are you? and thank you for your reponse and can i have your
personal mail id so that i can send mails directly to you.

        Its was a very kind gesture by in helping me out, once again thank you for your reply.

Thanks
Renato Pereira

Bianca
September 7, 2006 @ 1:40 PM Reply  |  Email Friend   |  |Print  |  Top

Biancag31@hotmail.com

Donna
October 25, 2006 @ 10:02 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Everyone,

I wanted to know for those who specialize in Chiropractic biling, how did you go about marketing to them?  I have experience in Psychiatric billing, but for some reason not getting too many responses, so I'm thinking of just marketing to all providers.  I currently work for our local Medi-Cal office and I process many of those claims.  Can anyone give me and pointers or directions?

Thanks
Donna
www.wekarebillingservice.com

Tammy Harlan
October 27, 2006 @ 1:51 PM Reply  |  Email Friend   |  |Print  |  Top

Hi Donna,

Misery loves company --- so when I initially began marketing to chiropractors, I researched and focused on the problems that were present in chiro offices across the board.  One example that I can give is "getting paid on workers compensation claims" (which is detailed in an article in the next issue of BC Advantage Magazine).  Simply put, I determined what the offices were collectively doing wrong --  and then I addressed these issues in my marketing campaign (flyers, cold calling, post-cards, etc.).  Focusing on problems gets their attention because they can relate to the information and it gives them a reason to pick up the phone and give you a call.  Works great!

You can search google to find common billing and reimbursement problems for chiropractors.

Good luck to you!

Tammy Harlan
Medical Billing Course
www.medicalbillingcourse.com

andrew
January 28, 2016 @ 4:17 AM Reply  |  Email Friend   |  |Print  |  Top

hi

hope you are doing very well, actually, uhc denied cpt g0283 do you have any guidlines ? please email me.



Copyright © 2008 Billing-Coding Inc