Level of service

KoBee

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I read usually a chiropractor would rarely bill level 4 or 5 but most common would-be level 2 or 3.

But I'm having trouble when to determine Dx of back, low, neck pain would fall under problems addressed and procedure treatment of manipulation. Straightforward or low?

Anyone run into these cases or have any good chiro sources they would like to share?

Help :/
 
Hi KoBee. Are you talking about the Exam Codes, 99202-99205 and 99212-99215? These are coded differently since their revision in 2021. The code to bill can be based on Time or it can be based on MDM (Medical Decision Making). MDM involves different factors, including complexity of the problems addressed. Here is the link to the AMA guidelines (go to the 2021 summary Revisions section): https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
 
I read usually a chiropractor would rarely bill level 4 or 5 but most common would-be level 2 or 3.

But I'm having trouble when to determine Dx of back, low, neck pain would fall under problems addressed and procedure treatment of manipulation. Straightforward or low?

Anyone run into these cases or have any good chiro sources they would like to share?

Help :/
Hi KoBee. Are you talking about the Exam Codes, 99202-99205 and 99212-99215? These are coded differently since their revision in 2021. The code to bill can be based on Time or it can be based on MDM (Medical Decision Making). MDM involves different factors, including complexity of the problems addressed. Here is the link to the AMA guidelines (go to the 2021 summary Revisions section): https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management
 
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