Updated 3-19-2020 On-Line Digital Evaluation & Management Services (New 2020) Providers who have patients that cannot make appointments due to need for isolation, quarantine, or social distancing may still need your management and when done as an online evaluation or phone call there are two code sets that may fit Read more…
The Medicare ABN will have a revision and update this month as the prior expires at the end of March this year. The new form will have some revisions to make it âeasierâ to use and explain and once it is published will be required to replace the older version. Read more…
The standard Medicare Advance Beneficiary Notice (ABN) will have some modifications in March 2020. The new forms will be required once published. There are some minor changes to the form with special instructions and needs for an ABN for a non-par provider not accepting an assignment. The new forms once Read more…
UHC has announced they will no longer offer any benefits for out of network providers  for chiropractic, acupuncture, and physical medicine. To maintain payment providers must now enroll with UHC to maintain payments for any of the above services. For chiropractic providers typical enrollment is through Optum Health.
Noridian Medicare specifically regions JE California, Hawaii, Nevada, American Samoa, Guam and the Northern Mariana Islands. Region JF Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming. Have had all chiropractic claims denied improperly with a reason code of CO50, not medically necessary. Noridian Medicare has Read more…
Optum Health will begin covering the VA for states essentially east and north of Texas. If youâre a provider in VA CCN Regions 1, 2, or 3 and youâre transitioning to Optum for the new CCN contract, you can still accept TriWest authorizations during any overlap period and bill for those services. Read more…
California Blue Cross Claims submitted on or after October 1, 2019 will be subject to a ninety (90) day timely filing requirement, and Blue Cross will refuse payment if submitted more than ninety (90) days after the date of service. If Plan is the secondary payor, the ninety (90) day Read more…
Recent claims for VA under the PC3 program We have noted recent payment denials for manual therapy 97140 and massage 97124 even with GP and 59 modifiers. It appears the VA is adopting the CCI edits and bundling both codes to CMT when done to the same region. This, of Read more…
Horizon BCBSNJ previously announced plans to collaborate with American Specialty Health (ASH) to implement and administer their Chiropractic & Physical Medicine Services Program for acupuncture, chiropractic, occupational therapy, physical therapy and speech therapy, effective January 1, 2020, subject to regulatory approval by the New Jersey Department of Banking and Insurance. Read more…
2020 ICD10-CM Updates 71,932 codes in ICD10-CM 2018 72,184 codes in ICD10-CM 2019 273 New Codes 21 Deleted Codes 30 revisions As occurs every October 1 there are additions and deletions to the ICD10 code set. This year is had very minor updates and changes related to chiropractic coding and Read more…