Medical Necessity Template Letters

Download Support Tools

Sometimes, third-party payers require pre-authorization, or a denied claim may need to be appealed with information about the clinical basis for orthotics prescription. These support tools are editable template letters with suggested content to use when submitting this information. Download, review and save these documents for future use. NOTE: Once you click on the resource, look for the document in your downloads or taskbar. Unlike a PDF, these will not open up on your desktop.

Sample Letter of Medical Necessity for Custom Functional Orthotics
Letter of Medical Necessity and Pre-Authorization for Functional Orthotics-Template

What Do They Want From Me?

A Records Request: A Common Occurrence So, you check the office mailbox – a few EOBs, checks from patients, a menu from the local pizza place, and (sigh) a love note from an insurance company requesting records for a patient. Before panic sets in, understand that this is a common occurrence in the chiropractic profession....
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The Idiosyncrasies of Hot/Cold Packs

Guidance on CPT Code 97010 Code 97010 is a code that is often misused and overbilled. The most common reason is that it is difficult to establish and prove medical necessity for this service and, very often, the documentation does not include appropriate rationale for using this code. Below you will find what the American...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

CMT Reference Documents

 Reference Documents It’s critical to know the rules of the game that you are sitting down to play when billing third-party payers and dealing with CPT® coding. In this section, we’ve provided three excellent reference documents that outline more information about the CMT codes, from three different perspectives. Note the Job Aide from Medicare that...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

CMT & E/M Coding

CMT & E/M Coding Expectations  There are many occasions when it may be necessary to perform both an Evaluation and Management (E/M) service (9920X or 9921X) and a Chiropractic Manipulative Treatment (CMT) service on the same date. Such examples include: New patient visits Established patients with new conditions, new injuries, aggravations, or exacerbations Periodic re-evaluations...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.