Chiropractic Coding & Compliance Alert

Published on Tue May 12, 2015 PDF

Question: How does one go about filing a claim for chiropractic services rendered to an outpatient in a hospital?

New York Subscriber

Answer:  While submitting such a claim to the Part A MAC, keep the following in mind:

• The hospital should report the full ICD-9-CM code for the diagnosis shown to be chiefly responsible for the outpatient services in FL 67. If no definitive diagnosis is made during the outpatient evaluation, the patient’s symptom is reported. If the patient arrives without a referring diagnosis, symptom, or complaint, the provider should report an ICD-9-CM code from the categories of Persons Without Reported Diagnosis Encountered During Examination and Investigation of Individuals and Populations (V70-V82).

• The hospital enters the full ICD-9-CM codes in FLs 67A-67Q for up to eight other diagnoses that co-existed in addition to the diagnosis reported in FL 67. 

Related Articles

Reimbursement: Make the Grade With ACA's New PQRS Reporting Recommendations

Reimbursement: Take a Giant Leap Forward in Payments with the New "X" Modifiers

You Be the Coder: Documenting a New Follow-Up Functional Outcome Assessment