Medicare Archives

The Nuances of Medicare Billing

Medicare plays by its own set of rules. These rules may or may not follow those of other carriers. Medicare’s rules have a nuance all their own (e.g., chiropractors are one of three types of practitioners who can never opt out of Medicare). Medicare also has a specific set of modifiers that help make billing…

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Excluded Service Modifiers Can Make or Break Your Claims

Now that you’ve learned about the difference between modifiers for spinal CMT codes, and those for excluded services, let’s dig a bit more into two critical excluded service modifiers. The GP and GY modifiers may seem unimportant because they are appended to codes that are not covered by Medicare. But misuse or omission of either…

Examine Medicare Modifier Usage

This colorful, visual reference discusses modifiers and some of the acronyms used and misused in coding. It is offered as a down-to-earth dialogue that is easy to read and makes the information easy to retain. Study it and share it with your team members to provide a better overview of Medicare modifiers in your practice.

Medicare Modifiers Make All the Difference

Medicare modifiers are possibly the most important component in accurate Medicare billing. Understanding and using the right modifier for each situation will reduce delays in payments and lower the number of denied claims. Modifiers provide context for the story of the patient’s experience in the office and clarify important payment considerations necessary for processing. These…

Medicare’s Documentation Reference Documents

Download Reference Documents Medicare publishes helpful documents and alerts to keep providers in the know about important topics. Included here are several documents that relate specifically to documentation of Chiropractic care and medical necessity. These tools relate to the elements of Chiropractic documentation and the overall rulebook for Medicare policy, The Benefit Policy Manual. Download,…

Incident, Burst, or Episode

Download Support Tool The terms incident, burst and full episode were coined by us here at KMC University as a way for providers to consider the length of an episode of care. When sitting down to document the initial visit of a new episode, consideration of the potential length of the episode can be put…