Navigating chiropractic billing involves intricacies in submitting and reconciling insurance claims for services provided by your biller. Unlike billing in other medical specialties, chiropractic medical billing requires understanding a distinct set of procedures and codes.
Challenges in Billing for Chiropractic Services
The challenges in chiropractic billing are numerous and can significantly affect the efficiency and effectiveness of the billing process. Staying updated with the continuously evolving CPT codes and insurance payer policies stands out as a primary challenge. This necessitates ongoing education and adaptation to ensure compliance and accuracy in billing practices.
Managing claim rejections and denials is another critical challenge in billing for chiropractic services. Effectively addressing these issues often involves a thorough review of each claim to identify and rectify errors or discrepancies before resubmission. This proactive approach is essential for minimizing disruptions in cash flow and ensuring timely reimbursement.
Patient management also presents its own set of challenges within the realm of chiro billing. Communicating treatment costs, insurance coverage details, and any out-of-pocket expenses to patients can be complex. Clear and transparent communication is crucial to help patients understand their financial responsibilities and make informed decisions regarding their care.
Delays in payment can pose financial challenge for your practice. Effective communication with payers and patients can help resolve these issues.
Access to reliable chiropractic billing resources and tools is indispensable for your clinic and biller. These resources offer valuable guidance and support in understanding and completing billing forms accurately. By leveraging these tools effectively, chiropractic practices can streamline their billing processes, ensuring prompt and accurate reimbursement while delivering high-quality care services to patients.
Top 8 Free Resources for Chiro Billing
1. AAPC Free Tools
AAPC provides a range of free tools to simplify chiropractic medical billing services. Enhance your documentation speed and accuracy with the following tools:
1. E/M Calculator: This tool assists in selecting the correct evaluation and management (E/M) code based on the date of service, incorporating both 1995 and 1997 Documentation Guidelines along with the latest updates.
2. RVU Calculator: Keep track of work relative value units (wRVUs) associated with CPT® or HCPCS codes to monitor resource utilization.
3. Risk Adjustment Search: Easily map diagnoses or ICD-10 codes to hierarchical condition categories (HCCs) using this quick search tool.
4. Claim Denial Calculator: Determine the financial impact of claim denials on your business by calculating both revenue loss and rework costs.
5. ICD-9 to ICD-10 Code Conversion Tool: Compare ICD-9 codes with ICD-10-CM using this code translator tool to ensure accurate coding.
6. ICD-10 Mapping: Simplify ICD-9 to ICD-10 code mapping for health plans and providers, including forward and backward mapping and additional code choices.
7. CPT Code Search: Search for CPT® codes by keyword, code, or code range to easily find relevant codes for medical procedures.
8. E/M Utilization Tool: Assess the utilization of E/M codes in your practice to optimize coding efficiency and compliance.
2. ChiroCare
ChiroCare is the largest Upper Midwest network of chiropractors. ChiroCare provides a preliminary list of common ICD-10 codes for chiropractic diagnoses. Please be aware that this list is not exhaustive and may not encompass all ICD-10 codes accepted by Fulcrum. It is intended solely as a reference guide.
- CMT Coding Guideline
- Passive Modalities Coding Guideline
- Therapeutic Exercises (97110) Coding Guideline
- CMT Coding Guideline
3. ChiroCode
ChiroCode is a leading provider of resources and tools designed specifically for chiropractors, aimed at simplifying various aspects of their practice. With a focus on efficiency and accuracy, ChiroCode offers a range of solutions to assist chiropractors in navigating the complexities of medical coding, billing, and documentation. Let’s explore some of the essential tools provided by ChiroCode:
Medicare’s Resource Based Relative Value Units (RBRVS) Fee Estimator: Quickly estimate fees using Medicare’s RBRVS system, ensuring accurate reimbursement for billing for chiropractic services rendered by you/provider.
- Online Library: Access a comprehensive online library of resources and tools through a Find-A-Code subscription, providing chiropractors with a wealth of features to enhance practice management.
- HCPCS Code Search: Simplify the search for the right HCPCS codes with Find-A-Code’s extensive database, streamlining the coding process and ensuring accuracy in chiro billing.
- ICD-10-CM Code Search: Effortlessly locate the correct ICD-10-CM codes using Find-A-Code’s extensive database, facilitating accurate diagnosis coding and documentation.
4. Medicare Coverage by CMS
This article outlines billing and coding guidelines for Chiropractic services covered by Medicare through the Centers for Medicare & Medicaid Services (CMS). It’s important to note that Medicare coverage for chiropractic medical billing services is restricted to a limited benefit. Specifically, Medicare covers manual manipulation for the treatment of subluxation. In chiropractic terminology, “subluxation” refers to a spinal vertebra that is misaligned compared to the surrounding vertebrae.
5. Education Resource by HHS
Check out this article issued by the Centers for Medicare & Medicaid Services (CMS), as published on the HHS government site. This article will assist chiropractic billers in accessing the appropriate resources for accurate billing. This comprehensive resource serves as a guide for chiropractic documentation and billing, ensuring adherence to CMS guidelines.
6. ACA Coding Documentation
Under the direction of the ACA Coding Advisory Board and representatives to the AMA CPT® and RUC coding process, ACA Today provides coding, documentation, and reimbursement aids. As an ACA member, you have access to coding alerts and guidance to support your practice.
7. The National Correct Coding Initiative (NCCI)
The National Correct Coding Initiative (NCCI) by the Centers for Medicare & Medicaid Services (CMS) aims to standardize correct coding practices and minimize coding errors, ultimately reducing improper payments in Medicare Part B and Medicaid claims.
For Medicare-specific information and edits related to the NCCI program, please refer to the Medicare National Correct Coding Initiative page.
Similarly, for Medicaid-specific information and edits concerning the NCCI program, visit the Medicaid National Correct Coding Initiative page.
8. Complete Chiropractic Billing Guide by zHealth
Discover the ultimate resource for billing in 2023 with zHealth’s The Complete Guide to Chiropractic Billing. Dive into a wealth of knowledge encompassing chiropractic CPT codes, diagnoses codes, modifiers, and the intricate world of chiropractic billing and coding. In this all-inclusive guide, you’ll not only discover the right chiropractic CPT codes to be used for different procedures in 2023, but it also includes essential updates regarding ICD-10 that you should keep in mind throughout this year. Learn what are the most common chiropractic modifiers in 2023, so you can avoid claim denials related to missing or wrong modifiers.
Read More: Maximize your Revenue with our Free Chiropractic Billing Calculator
Conclusion
You can streamline your chiropractic medical billing process in-house with user-friendly, automated chiropractic billing software like zHealth. Our software offers features and resources designed to simplify chiropractic claims processing, resulting in practices receiving payments up to 12 days sooner.
For practices with a high volume of monthly claims, outsourcing chiropractic claims billing to an expert chiropractic billing company with specialized expertise can yield numerous advantages. Managed billing services handle tasks such as reviewing ICD-10 and CPT codes and managing claim denials. As a chiropractic billing company, we can help you streamline operations, reduce error, and increase revenue.
Reach out to zHealth’s Managed Billing Experts to get a free analysis of your billing process. We will help you discover how we can assist you in eliminating the hassles of denied claims, reducing administrative burdens, and focusing on delivering top-notch care to your patients.
