tci Medicare Compliance & Reimbursement - 2016 Issue 20

Reimbursement: Notes and Necessity Are Essential for Chiropractic Claims to Be Paid

With chiropractic claims, it is wise to consult your MAC on what’s required. Documentation—it is the cornerstone of thoughtful medicine, and the details of these expert reports help providers and coders alike prevent denials and overturn audits. The notes determine whether the treatment is medically necessary, and with chiropractic care, that can be the difference between collecting for your services or facing a denial. Background.There is no subtlety associated with coding chiropractic services under Medicare, and the CMS policy clearly states that services must be deemed medically necessary for payment. Here lies the importance of the...

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