Therapy-Modality Cheat Sheet Supportive Therapies are a great addition to the primary Chiropractic Adjustment. Sometimes, these therapies are the primary or only therapeutic procedure delivered to the patient during a routine visit. Documentation requirements by various regulating bodies or payors detail the specific information needed for these therapies. This page is a printable tool illustrating…

Extraspinal CMT Codes – Modify or Not? There are a few times when you append a modifier to Chiropractic Manipulative Treatment (CMT) codes (e.g., when billing CMT to Medicare, the proper modifiers are appended as required by Medicare (see the Fact Sheet titled Commonly Used Medicare Modifiers)). Other than Medicare, you should consider two things…

What to Do if Modifier 25 Gets Denied In the realm of coding and documentation, it is often thought that “more is better.” However, when it comes to adding the 25 modifier to Evaluation & Management (E/M) services, it is important to understand when it is really needed and when it’s best to leave it…

When to Use Modifier 25 (And When Not To) If the work of both a Chiropractic Manipulative Treatment (CMT) and a distinct Evaluation & Management (E/M) service are performed on the same day, it’s completely appropriate to bill both. At other times, while it may be clinically indicated to assess a patient’s condition prior to…

How We Communicate to a Payer It can be said that modifiers are “all about the money.” By using these very powerful two-digit codes, we communicate to an insurance company or another payer that something is different about the services as they relate to the CPT code being billed. Because modifiers can cause an increase…

The modifier “-25” is a source of frustration for doctors of all sorts.  What code(s) do you attach it to?  Can you use it every visit with CMT or PT codes? The insurance companies keep denying my procedures even though I think I am billing it properly.  What should I do?! -25 is an important…