The CERT program’s review of claims for chiropractic services has consistently yielded high improper payment rates. The majority of chiropractic services claims were the result of insufficient documentation, such as:

This Special Edition (SE) MLN Matters® article is intended for Chiropractors submitting claims to Medicare Administrative Contractors (MACs) for chiropractic services provided to Medicare beneficiaries. CMS is providing this article in order to provide education for chiropractic billers on accessing the correct resources for proper billing. This article is intended to be a comprehensive resource for chiropractic documentation and billing.

Attention NYSCA Members,

As many of you are aware the NYSCA Workers' Compensation Committee has been working with Broadspire and Sedgwick after issues were identified with inappropriate denials of Chiropractic Manipulative Therapy rendered within the recommendations of New York's Medical Treatment Guidelines.

News and Alerts NGS Medicare

On March 28, 2016 the NYS WCB hosted an informational webinar and feedback session regarding the web based Medical Portal they have been developing. It was attended by the NYSCA WC Committee. As you may know, this is part of the larger Business Process Reengineering Project that they have been undergoing and the NYSCA has been engaged in for several years.

The Centers for Medicare and Medicaid Services (CMS) recently published a series of three Special Edition educational articles for DCs submitting claims for services provided to Medicare beneficiaries. MLN Matters® articles SE1601, SE1602 and SE1603 provide guidance on improving billing and documentation of chiropractic services, increasing compliance with Medicare regulations and reducing the profession's claims error rate. Also available are ACA's related resources here.

Dear Colleagues:

In brief:

With the implementation of ICD 10 on October 1, 2015, it is important to use the appropriate ICD Indicators on claim submissions.

On October 1 the United States health care community transitioned to ICD-10. CMS wants providers to be successful in using ICD-10 and remains committed to working with industry on the transition.

USE OF ICD-10 CODES