Insurance news
The Post-ICD-10 World
Written by Dr. Ray Foxworth   
Wednesday, January 20, 2016 12:00 AM

ICD-10 woes are an “insider issue” that your patients don’t want to hear about.

If you’re reading this, you made it past ICD-10’s transition date, and you’re still here to tell about it. Now that the implementation date is behind us, this is a good time to regain perspective and remember that even something as big as ICD-10 is only a part of your practice. Certainly it has nothing directly to do with your commitment to your patients or your relationship with them.

In other words, ICD-10 is an insider issue—one your patients should ideally never even hear about. So no matter how top-of-mind this transition may continue to be make sure the frustration, overwhelm, and distraction don’t make their way to your front desk or your exam table. Your patients don’t want to hear about your coding and financial department issues.

Changes to X-Ray Codes for 2016
Written by ACA   
Wednesday, January 20, 2016 12:00 AM

The American Chiropractic Association reports that CPT® has made some changes to a few commonly billed x-ray codes. The AMA/Specialty Society Relative Value Scale (RVS) Update Committee (RUC) Relativity Assessment Workgroup (RAW) marked codes 72170, 73500, 73520, and 73550 for “restructuring as bundled services for hip, pelvis, and femur.”

As a result, CPT® added “a new family of six bundled codes (73501-73503, 73521-73523) for hip and pelvis radiologic examination with a specific number of views.” These will replace deleted codes 73500, 73510, 73520, 73530, 73540, and 73550. In addition, “two new codes (73551, 73552) were established to describe the specific number of views of the femur... in order to more clearly define the work performed, and to reflect current clinical practice.”

The thoracolumbar procedures have been updated with the addition of four new codes 72081-72084. These will replace deleted codes 72010, 72069, and 72090; and the revision of code 72080. According to CPT®, “these changes simplify the reporting procedures for scoliosis evaluations and other studies; address current changes in clinical practice; and provide a coding structure similar to the structure of other imaging families.”

The table below explains the changes that were made to these codes, effective January 1, 2016.

Top 5 ICD-10-CM Billing Errors
Written by Editor   
Tuesday, January 19, 2016 12:00 AM

Here are the top five billing errors made with the new ICD-10 system.

In an effort to prepare the profession for the monumental change to the new ICD-10 coding system, ACA developed a variety of helpful resources. In order to assist clinics in avoiding rejected, denied, or delayed claims, we have listed the top five most commonly seen billing errors for your consideration.

ACA Coding & Insurance Tips, Dec. 2015
Written by Editor   
Sunday, December 20, 2015 10:43 PM

Coding specifics and payer updates from the ACA will help you to stay current with billing procedures.

Q. How do I code laterality with sciatica if the patient experiences symptoms in both legs?

Acupuncture and Chiropractic Care Utilization
Written by Editor   
Monday, November 30, 2015 09:27 AM

A recent study underscores why so many chiropractic patients have to go “out of network” in order to get the care they need: Managed care appears to be be effectively locking them out. This study reviews chiropractic and acupuncture utilization by adults with chronic musculoskeletal pain at Kaiser Permanente Northwest, an HMO.

Evidently, physician referral for acupuncture is strictly limited to chronic pain complaints, while referral for chiropractic benefits is limited to acute pain. This is why 43-54% of those individuals who sought chiropractic care had to seek “out-of-plan” (aka out-of-pocket) care.  Physician referrals within this Kaiser program was tipped in favor of acupuncture, with 55% of them being referred for care, versus only 9% of the chiropractic patients.

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