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  1. M

    Wiki Coders for Insurance Companies

    Good Morning! I work for an auto carrier in PA as a coding supervisor. The question came up as to what other types of insurance companies employ coders, and what type of responsibilities those coders have. I supervise a team of coders that audit the medical claims that are billed to us for...
  2. M

    Wiki DO billing Chiro Manipulations

    Can a doctor of osteopathy bill for chiropractic manipulations (98940-98942)? I know that CPT/AMA does not define the word "provider" and refers you back to your state guidelines (I'm in PA) and that the outcome of chiropractic manipulations is different than the outcome of osteopathic...
    • mwagone1
    • Thread
    • 98940 98941 chiropractic coding manipulation osteopathy
    • Replies: 2
    • Forum: Chiropractic
  3. M

    Wiki Percutaneous Electrical Nerve Stimulation

    Novitas, the Medicare MAC for PA has an LCD (L32710) listing PENS as an example of G0283. I've found many BCBS/Aetna and other payor documents stating they recognize PENS as 64999. I work for a payor that follows Medicare guidelines. Does anyone know what is the most appropriate code for...
  4. M

    Wiki Chiropractor billing kinesio taping

    Kinesio Taping I agree with Brian, I work for a payor and we do not pay strapping (used to immobilize) for kinesio (used to assist in movement) taping. We accept 97112 for kinesio taping.
  5. M

    Wiki Anesthesia, ASC, Pmgt

    Thank You! Thank you DWALDMAN for all of your assistance, it was a wealth of information that supported what I had initially thought. I appreciate the time you took for your reply. Thanks again!! Melissa
  6. M

    Wiki Anesthesia, ASC, Pmgt

    I work for a payor and have come across the following scenario: ASC is billing for the surgery codes (usually spinal injections) Anesthesiologist is billing for the anesthesia code Surgeon/Pain Management physician is billing for the meds injected for both the spinal injections (Kenalog...
  7. M

    Wiki ASC/Anesthesia/Surgeon billing

    I work for a payor and have come across the following scenario: ASC is billing for the surgery codes (usually spinal injections) Anesthesiologist is billing for the anesthesia code Surgeon/Pain Management physician is billing for the meds injected for both the spinal injections (Kenalog...
  8. M

    Wiki MDM/Risk Table in an ED setting

    As a Pennsylvania Auto insurer, we reimburse per Medicare guidelines (at a 110% of Medicare Fees). I was wondering if anyone could offer some insight in regards to coding head injuries without brief LOC. We use the Medicare Scoresheet and know that it is only a guide, that we do have to make...
  9. M

    Wiki e/m

    I would recommend using Medicare's 1995 scoresheet https://www.novitas-solutions.com/em/scoresheets.html
  10. M

    Wiki Chiropractic and Medicare Regs??

    I'm on the payor side, but we follow Medicare guidelines, so your best bet is probably going to be to consult your states Medicare carrier's LCD regarding chiropractor services. This should clarify exactly what is billable/reimbursable. Good luck :)
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