Documenting for Chiropractors and Podiatrists

In 2007, Medicare is going to continue their close scrutiny of chiropractors and podiatrists. The claims submitted by these fields will continue to get looked over due to the extreme amount of fraud that has occurred in these two branches of medicine. Additionally, the stringent guidelines that are currently in place for chiropractors and podiatrists in order to meet payment requirements for certain procedures and debridement services will be getting looked at very closely and continue to be required in order to get their medical billing claims paid.

If you perform these services or you are a medical billing company that does claims for these types of practices, check and double check your medical billing for the proper documentation before filing your claims to avoid delays in reimbursements or outright rejections of your medical billing claims. The modifiers used on these claims will be getting extra close scrutiny. Make sure you are descriptive in your medical billing as possible and don’t just use the maintenance visit coding on your medical billing claims, that is sure to raise a red flag and get your claim denied. Make sure to document all procedures done on your medical billing claim that can add up to the necessity of all procedures performed, this gives the whole picture to the carrier and will result in full reimbursement of your medical billing claims.

The last estimate in the Red Book is Medicare could save nearly $285-million dollars per year if chiropractic procedures such as maintenance services, were no longer covered by Medicare. Over $186-million dollars were paid out to chiropractors in previous years for non-covered maintenance services performed.

View all Articles by: Kathryn E, CCS-P - Retired