{"id":5983,"date":"2020-12-27T15:12:17","date_gmt":"2020-12-27T21:12:17","guid":{"rendered":"https:\/\/pmaworks.com\/observations\/?p=5983"},"modified":"2020-12-28T07:58:28","modified_gmt":"2020-12-28T13:58:28","slug":"5983-2","status":"publish","type":"post","link":"https:\/\/pmaworks.com\/observations\/5983-2\/","title":{"rendered":"New Year = Coding Changes."},"content":{"rendered":"

\"\"<\/p>\n

As we leave the crazy year of 2020 and enter a fresh 2021, here is a summary of\u00a0 Coding changes taking place that impacts your clinic operations and bottom line:<\/p>\n

I. CPT Code 99201<\/strong> is being deleted<\/strong> effective 1\/1\/2021<\/p>\n

A. Documentation for CPT Codes 99202 through 99205 will be required using criteria of Medical Decision Making OR<\/strong> Time element to determine the level of coding.<\/p>\n

o Medicare requirements remain the same for medical decision-making criteria using P.A.R.T. (Pain, Asymmetry\/misalignment, ROM decrease, Tissue tone changes) OR diagnostic imaging with documented report of objective findings.<\/p>\n

B. CPT 99211 (re-exam) is not being deleted but not used very frequently, and some payers do not pay chiros for this code. You may still bill 99211 when a CT licensed in history-taking and exams performs a re-exam.<\/p>\n

C. The 2021 treatment plan model will be the same as 2020:<\/p>\n

o Number 1 documentation priority Medicare is looking for: Goals<\/strong> (time or distance element, for example ADLs or specific exercise)
\no Number 2 element = duration of care<\/strong> (for example 24 visits)
\no Number 3 element = frequency of care<\/strong> (Example – 2X\/week for 12 weeks)<\/p>\n

II. Changes to ICD-10 codes relevant in chiropractic<\/p>\n

1. The following codes have been Added:<\/strong><\/p>\n

A. Arthritis of temporomandibular joint<\/p>\n

i.\u00a0 \u00a0M26.641<\/strong> right
\nii.\u00a0 M26.642<\/strong> left
\niii. M26.643<\/strong> bilateral
\niv. M26.649<\/strong> unspecified<\/p>\n

B. Arthropathy of temporomandibular joint<\/p>\n

i.\u00a0 \u00a0M26.651<\/strong> right
\nii.\u00a0 M26.652<\/strong> left
\niii. M26.653<\/strong> bilateral
\niv. M26.659<\/strong> unspecified<\/p>\n

2. Deleted ICD-10 Codes:<\/p>\n

A. M92.50, M92.51, and M92.52 deleted. (Juvenile osteochondrosis). Use M92.8 or M92.9 instead
\nB. R51 (this headache code deleted). Here are two specific codes added, to use instead:<\/p>\n

i. R51.0 Headache with orthostatic component, not elsewhere classified
\nii. R51.9 Headache, unspecified<\/p>\n

III. Medicare 2021 Reimbursement on covered CMT<\/strong>
\nPlease note a significant reduction in reimbursement across the board for select specialty physicians and surgeons. Here is the chiropractic fee schedule:<\/p>\n

\"\"<\/a><\/p>\n

Referring back to the exam discussion above, you may want to consider raising your E\/M code fees. However, be advised insurances will not reimburse at your full fee, and Medicare as well as most Part C plans as of this writing do not pay for exams performed by Doctors of Chiropractic. These charges are patient responsibility.<\/p>\n

Questions? We\u2019re here to help!<\/p>\n

Call 920-334-4561 or email lisa@pmaworks.com<\/a><\/p>\n

Cheers!<\/p>\n

~Lisa Barnett
\nIncreasing your collections through better billing and documentation.<\/em><\/p>\n

References:<\/p>\n