Billing and Coding Considerations for Orthotics

All codes are not the same – just because a code is covered by a health plan, it doesn’t mean it describes the functional orthotic being prescribed in your practice. Likewise, although we know that functional orthotics are proven to make a difference in lower back and other spinal pain that doesn’t mean the patient has a benefit for that diagnosis. This overview tutorial outlines best practices for proper HCPCS coding, modifiers, and ICD-10 coding necessary for payment.  


Documentation Drives Coding

Download Support Tool Far too often, we find a fancy code (maybe a new code) and want to find a way to charge for it. This is completely backward. Documentation must drive coding. This simple visual reminder outlines the process of starting with the documentation and coding from there. Utilize this concept to reinforce the...
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Medicaid Reference Documents

Download Reference Documents Most of the resources a clinic will need can be found on the dedicated Medicaid website for their state. Listed below are some resources developed by CMS that can assist with understanding key aspects of the Medicaid program. How to Use the Medicaid National Correct Coding Initiative (NCCI) Tools Medicaid Provider Enrollment...
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Manual Therapies, Play and Stay in the Game

Manual Muscle Therapy lives in the Physical Medicine Bucket We understand the thrust to help your patients commit to and sustain a pain free, fully functional, and productive lifestyle, is of your practice’s highest order. Manual Therapies can be a stable and productive part of any type of practice, insurance or self-pay based. To implement...
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Coding Therapeutic Activities – 97530

Therapeutic Activities – 97530 Therapeutic Activities are an asset to any office when coded and documented correctly. It is important to note that the guidelines for this code may vary, depending on individual state laws or provider contract provisions. Complete a Verification of Benefits for each patient to determine specific requirements. Guidelines are different if...
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Proper Use of S8990

Code S8990 & Maintenance Care Service codes (CPT/HCPCS) tell a third party what you are doing with the patient.  As with all coding, even maintenance care must be properly coded to clearly communicate in the patient record within your software, and for any authorized third-party that may have access to this data. S8990 Explanation Definition...
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