PART and ROV The PART process, an examination method intended to quantify the presence of a subluxation for Medicare, has been used for over two decades. The application of PART, as noted below, is critical in the initial visit of an episode of care to formulate the basis for medical necessity. However, when documenting the…
Documentation of Objective Findings Daily ROV
If a primary goal of a practice is to help people get better and achieve their functional goals, how can you determine if a patient is improving, regressing, or staying the same? You can’t rely solely on what the patient tells you as some patients unwittingly under report while others over report problems or progress. …
Use of the AT Modifier in Chiropractic
Medicare publishes helpful documents and alerts to keep providers in the know about important topics. The use of the AT modifier in Medicare is one of the most critical billing issues providers face. Absence of the AT modifier indicates that the service is maintenance in nature…and therefore, is not payable. Statistics show that overuse of…
Medicare Diagnosis Rules
As with all treatments and services in chiropractic, Medicare has its own set of rules, policies, and procedures. It is particularly important to be clear about the diagnosis rules regarding Medicare patients. You should review Medicare’s guidance in your Local Coverage Articles, and revisit them frequently to stay on-top of any changes. Doing so will…
Medicare Diagnosis Rules
For Medicare coverage, there must be a diagnosis of subluxation, along with a secondary neuromusculoskeletal diagnosis in a spinal region. Medicare has, in recent years, allowed for a wider variety of secondary code to couple with the segmental dysfunction primary code. This brief training outlines the Medicare guidelines and requirements for diagnosis, both in the…
Medicare’s Documentation Requirements for Medical Necessity
Medicare’s Documentation Requirements for Medical Necessity One of the most fundamental obligations in healthcare is proper medical record documentation. The Grandaddy of all requirements are those published by the Center for Medicare and Medicaid Services (CMS). Because there are few payers or state Boards of Examiners who have a stiffer requirement, mastery of Medicare’s documentation…