tci Part B Insider - 2016 Issue 30

Reader Questions: Know the Differences Between PT and Chiropractic Services to Avoid Denials

When referring patients to a chiropractor, make sure you understand what CMS covers. Question: In my orthopedic practice, we occasionally refer patients to a respected, local chiropractor. Recently, we sent an existing patient with chronic back pain over to him. The claims were denied because the services did not improve the symptoms. In last week’s issue of Part B Insider, you discussed what is an acceptable claim in detail. Can you explain why this might have been denied? --Alabama subscriber  Answer: “Chronic pain” is the key to the denial. CMS distinguishes the two different areas of...

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