Documentation & Coding Archives

Proving Medical Necessity Can Be a Pain in the “ASH”

Proving Medical Necessity Can Be… Painful. Medical necessity for chiropractic treatment is defined by third-party payers. The specific requirements are usually outlined in their medical review policies and the criteria must be met in order for services to be reimbursed. The doctor must not only perform the appropriate history and exam, but must also document…

Oops, your level of membership doesn’t include access to these full training courses. Please reach out to the HelpDesk to learn more about accessing these trainings and resources. Click here to learn more.

Medical Necessity Primers

The core concept of compliant documentation, billing, and coding is that of whether the service would be deemed medically necessary. A keen understanding of the difference between the two is an essential element of running the business of chiropractic. While the service provided may not be different, and the documentation may be similar when a…

Documenting Medical Necessity

Documenting Medical Necessity Proper documentation of the medical necessity for treatment begins with the patient’s initial intake and must be reported from visit to visit concluding with discharge from active treatment. Continuity is key – the documentation must match the diagnosis, the treatment provided, and the goals the patient is expected to meet. This process…

Defining Medical Necessity

Medically Necessary vs. Clinically Appropriate Care A properly trained and licensed healthcare professional, such as a Doctor of Chiropractic, can diagnose and develop a treatment plan for their patients. Their decision-making skills allow them to determine the frequency of the patient’s visits and what services the patients will receive. As long as the doctor exercises…

Medical Necessity and Case Management

The term, Medical Necessity, doesn’t always land well in the ears of Doctors of Chiropractic. This terminology is driven by third-party payers as a definition of a level of service that must be met to receive their reimbursement. However, medical necessity is also a requirement of most Chiropractic licensing boards and can be in the…

Amendments-Corrections-Delayed Entries

Download Reference Document Medicare understands, Chiropractors can be wonderfully effective providers, yet they often make unforced errors in the documentation. Also, it’s clear that providers may become aware of pertinent patient information needed to add to a completed note. This Reference Document is Medicare’s own Change Request document that outlines exactly what they are looking…