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…
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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…
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Download Support Tools Doctors communicate their clinical procedures, services, and dispensing DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics and Supplies) through CPT and HCPCS II coding to third party payers, and for in house billing. There are times when claims get denied because the payer needed additional detail attached to a CPT or HCPCS II code,…
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Modifiers Clear Up Confusion It is truly wonderous how we can communicate across the country and globe at the touch of keystrokes compressed into computer language(s). The Chiropractic office gets paid by third parties by communicating their procedures, services, and other items through codes, which are matched and describe them to the highest specificity. This…
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Code Appropriately Once the office has determined that Kinesio taping can be billed to a third-party payer, the services must be coded appropriately. While it may not be reimbursable from insurance, the services must still be appropriately represented within the patient’s account. There are options for billing and coding these services, but there are several…
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Payer Policy Rules the Game As with all services billed to third-party payers, one must look to the payer’s Medical Review Policy (MRP) to learn the rules of the game. Whether the practice is providing chiropractic treatment only or includes other modalities, the billed payer sets the guidelines for billing and coding and the provider…
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