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Wiki Chiropractic billing

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ccwell

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Seven Hills, OH
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Hi....Can a Chiropractor bill for an E/M 99203 and a manipulation code on the same day for a new patient?
 
Yes. Initial E&M services can be reported separately from any manipulations performed on the same day. Initial exam is for a new patient or a new condition.
 
You may want to append modifier -25 to the E/M to bypass any clinical edits just in case.
 
Yes you can, although as Super Specialist said you should use modifier -25 on the E/M. I do disagree with one point he made, and that is "new condition" is not a criteria for determining if a patient is new or not. Per CPT 2013: "A new patient is one who has not received any professional services from the physician/qualified healthcare professional or another physician/qualified healthcare professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years." There is no mention of new conditions in the guidelines. If your doctor or another doctor in the practice that is the same specialty and subspecialty saw the patient for anything (not just office visits) in the past 3 years, they are not a new patient.
 
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