soprano
Guru
Please help. I know nothing when it comes to billing for chiro. Chart note says:
Subjective Comlaints: Sharp pain in mid back. Dull pain in neck.
Level of pain: 5/10
Objective Findings: Spinal palpation fixation:
Cervical: 3 and 5
Thoracic: 3,6,7,11, and 12
Lumbar/Sacral: Bilateral SI
Muscle Palpation - Tension/Active Trigger Points
Paraspinals
Range of Motion (N=Normal L=Limited)
C-Spine: limited
T-Spine: limited
L-Spine: limited
Sacro-iliac: limited
Assesment:
Mobility: TX well tolerated
Relief Stage: Palliative
Plan:
Chiro adjustments: 3-4 areas of the spine adjusted shown in objective findings palpation fixations.
15 minutes meuromuscular reeducation/myofascial release (direct one to one patient contact)
Paraspinals
Provider billed:
98941 (Chiropractic manipulation)
97140-59 (Manual therapy)
We received a denial for the 97140 which states " Per Medicare's Correct Coding Initiative, this CPT is a component code of 98941. We acknowledge that you are billing this service with a modifier -59. However, your notes do not support the use of modifier -59.
Is there something missing in the documentation that the provider should have written to support the 97140-59? Please advise.
Subjective Comlaints: Sharp pain in mid back. Dull pain in neck.
Level of pain: 5/10
Objective Findings: Spinal palpation fixation:
Cervical: 3 and 5
Thoracic: 3,6,7,11, and 12
Lumbar/Sacral: Bilateral SI
Muscle Palpation - Tension/Active Trigger Points
Paraspinals
Range of Motion (N=Normal L=Limited)
C-Spine: limited
T-Spine: limited
L-Spine: limited
Sacro-iliac: limited
Assesment:
Mobility: TX well tolerated
Relief Stage: Palliative
Plan:
Chiro adjustments: 3-4 areas of the spine adjusted shown in objective findings palpation fixations.
15 minutes meuromuscular reeducation/myofascial release (direct one to one patient contact)
Paraspinals
Provider billed:
98941 (Chiropractic manipulation)
97140-59 (Manual therapy)
We received a denial for the 97140 which states " Per Medicare's Correct Coding Initiative, this CPT is a component code of 98941. We acknowledge that you are billing this service with a modifier -59. However, your notes do not support the use of modifier -59.
Is there something missing in the documentation that the provider should have written to support the 97140-59? Please advise.