Collaborative parenteral nutrition webinar coming December 9
This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage...
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Physical therapy plan of care requirements
When billing for rehabilitation therapy services, there are some documentation requirements that must be met to comply with the...
Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory...
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Update on Medicare Operations: Telehealth, Claims Processing, and Medicare Administrative Contractors Status During the Shutdown
View this notice from CMS regarding Medicare operations during the government shutdown.
Outlier reconciliation criteria for IPPS and LTCH PPS hospitals
View this information about outlier reconciliation criteria for IPPS and LTCH PPS hospitals and the latest CMS change request.
Modifier AT (active treatment) defines the difference between active treatment and maintenance treatment.
The AT modifier is required under Medicare billing to receive reimbursement for CPT codes 98940 - 98942. For Medicare purposes, the AT modifier is used only when chiropractors bill for active or corrective treatment (acute and chronic care).
Every chiropractic claim for 98940, 98941 and 98942, should include the AT modifier if active or corrective treatment is being performed. Claims that do not contain modifier AT will deny.
When your office receives a request for medical records to substantiate the chiropractic services you rendered and billed to Medicare, our nurse reviewers review the documentation and verify all the required documentation has been met. If you met the documentation requirements, the nurse reviewers will send the documentation to a chiropractic consultant to determine the medical necessity of the services. If you did not meet the documentation requirements, the nurse reviewers will deny the services based on the lack of documentation.
Yes, if you submit the initial examination findings with each billed subsequent visit when responding to medical documentation requested by us or the Comprehensive Error Rate Testing (CERT) program, it is acceptable.