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Disclaimer

The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Medicare

Guides on Medicare coverage of chiropractic services with detailed information on enrollment, appeals, ABNs, and other important compliance issues.  Members have full access to the material below and can email us with questions regarding any billing or compliance issue, please consider joining today if you need assistance.  

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Provider Enrollment

    • Chiropractor Qualifications
    • Steps for Enrollment
    • Effective Enrollment Date and Retroactive Billing

Chiropractic Coverage

    • Basic Coverage
    • Medical Necessity
    • Contraindications
    • Treatment Parameters 

Appeals

    • Levels of Appeals and Time Limits for Filing
    • Good Cause for Late Filing
    • Decisions Subject to Appeal
    • Who may File an Appeal
    • Representatives - Representing your patient
    • Levels of Appeals
    • Medicare Advantage Appeals

Documentation Requirements

    • Demonstrating Subluxation
    • Initial Visits
    • Subsequent Visits

Billing

    • CPT Codes and ICD-10 Codes
    • AT Modifier
    • Qualified Medicare Beneficiaries
    • Secondary Payer
    • Waiving Copay and Deductibles 

(ABN) Advanced Beneficiary Notification of Noncoverage 

    • ABN Form and Instructions
    • ABN Notice and Delivery
    • Triggering Events
    • When it is Mandatory to Issue an ABN?
    • When it is Voluntary to Issue an ABN?
    • Issuing the ABN
    • Routine Notice Prohibitions and Exceptions
    • ABN Modifiers


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Chiro Comply does not claim copyright over US Federal and State materials

CPT codes are copyright 1995-2024 American Medical Association. All rights reserved.


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Chiro Comply is a membership-based healthcare compliance firm that strives to bring high quality compliance guidance to small and medium sized chiropractic practices. 

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