Part B Insider (Multispecialty) Coding Alert

Published on Mon Oct 18, 2010 PDF

Part B practices that report chiropractic manipulative treatment code 98941 shouldn't be too eager to collect their reimbursement, thanks to a new prepayment review that this code will trigger when submitted to National Government Services, a Part B payer in Connecticut and New York.

Thanks to a previous review of this code that yielded an alarming 80 percent denial rate, NGS is taking no chances on paying erroneous submissions of 98941. "Medical records will be requested to verify medical necessity of the services provided, and that services were billed according to Medicare Program guidelines," NGS says in its review notice. "If the submitted documentation does not support 98941, the services will either be correctly coded to an appropriate/lower level (98940) or denied," the directive notes.

To read the complete prepayment notice, visit www.ngsmedicare.com.