2017 Medicare Fee Schedule
Medicare Parts A & B Appeals Process
Click here to download.
Diagnostic Codes Accepted by Medicare
Click here to download a list of diagnostic codes considered to prove medical necessity by Medicare.
ICD-10 Implementation Guide
All doctors of chiropractic must be converted to ICD-10 from ICD-9 on
October 1, 2014. To ensure your practice is ready, please download this implementation guide.
HIPAA Final Rule Announced: Compliance Date is September 23, 2013
The federal government has published its final regulations implementing
the "Health Information Technology for Economic and Clinical Health
(HITECH) Act,” part of the "American Recovery and Reinvestment Act of
2009” (ARRA), described by the head of the Office for Civil Rights (OCR)
in the Department of Health and Human Services (HHS) as "the most
sweeping changes to the HIPAA Privacy and Security Rules since they were
first implemented.” The new rules expand the obligations of doctors of
chiropractic to protect patients’ protected health information (PHI),
extend these obligations to business associates who have access to PHI
and increase the penalties for violations of any of these obligations. The
following outlines the changes physicians will need to consider as they
implement the new HIPAA requirements necessary by the September 23,
2013, compliance date. Read more.
Medicare 25-Visit Review Tips
GCA office and Medicare Subcommittee has received numerous calls
regarding the new Medicare rule that requires a records review after 25
visits in a 12-month period. Please note the rule is NOT based on a
calendar year, but a rolling year.
After the patient's 25th visit in a 12-month period, Medicare will automatically deny the visit, forcing D.C.s to file an appeal and send in records to substantiate the medical necessity. Read more.
Tips for Complying with a Medicare Review
Many doctors of chiropractic
have probably received a request for records on one or more Medicare
patients from CAHABA, the contractor/payor for Medicare in Georgia. It is vitally important to all of us that you comply with this
request and that your records meet the required standards to properly
document the medical necessity of your treatment. These reviews are
mandated by CMS to all local carriers to assure claims are properly
paid. If your records do not substantiate your care, the claim may be
denied, or if already paid, you may be required to refund the money. Read more.