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FAQ’s and Coding Tips for Billing Medicare After the 09/12/2016 LCD Change
By Mollie Frawley, R.N., FCA Help Desk Coordinator   
Tuesday, 20 September 2016
The September 12, 2016 coding and billing changes by First Coast Service Options (FCSO) have raised several common questions listed below.  These questions are better understood with a better understanding of both the documentation AND billing underlying mandates for covered chiropractic services:
  • Does the September 12th date apply to dates of service or claims submission dates?
  • Do you have a list of common NMS codes we can use?
  • Do I have to have a NMS condition for each subluxation region billed?
  • Can I use the same NMS condition for the different subluxation regions billed? For example low back pain for lumbar, sacrum and ilia?
  • In what order must I bill the diagnoses on the bill?
  • How do I bill when the primary insurer is PIP or Workers’ Compensation and they require different codes and billing instructions than Medicare?
  • Why can I only point to ONE diagnosis code in Field 14 on the bill? When did this start?

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Preparing for the Version 5010 Upgrade: Questions to Ask Your Vendor
By CMS   
Wednesday, 15 February 2012

Version 5010  refers to the revised set of HIPAA transaction standards; adopted to replace the current Version 4010/4010A standards. Every standard has been updated, from claims to eligibility to referral authorizations.

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