I understand your concerns in this matter but if the doctor performed the actual services and it is documented correctly you shouldn't have to worry about any ill feelings with sending out your claims. In this case I would put it on the documentation and send a corrected claim accordingly. If the documentation is more E&M based then send in the visit. If the patient came in and the office visit is very minimal and you have a extensive note on the adjustment then truthfully the office visit should never have been billed since the patient only came in for the adjustment. We all know that there are doctors out there that document only what they think is needed so I would review the documentation and code accordingly. If it happens to be the adjustment that should have been billed, it won't be because it costs more it will be based on what the can be supported by the doctors documentation and you should feel comfortable with that.
I hope that helps
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