Chiropractic coding is complex and requires both extensive training and accuracy.
Even the best chiropractors and staff members make occasional coding errors, but mistakes can be minimized with the right approach to coding.
Know your problem areas
If your coding errors consistently follow a particular pattern, you may need to create a list of your most commonly-misused codes. This helps you identify training gaps and determine a prevention strategy. At your clinic, the problem codes may reflect issues with certain types of insurance, with particular procedures or with types of codes.
“The only mistakes we have made in coding would be pertaining to the NF insurances, when we fail to bill adequately for re-evaluations every six treatments or so,” said Brian Zelasko, DC of Zelasko Soft Tissue and Spine in Orchard Park, NY.
Zelasko says that his office loses less from a missing code if they are receiving the maximum reimbursement rate. Since this extra code is only used every six to ten visits, it is easier to forget than a code used at every billing.
At other clinics, the coding problems to watch for happen with particular insurances. Richard Yost, DC, of Norwood Chiropractic & Sports Injury Center in Norwood, OH says that his office watches carefully for Medicare mistakes, as these have been their most common sources of coding errors.
Practice thorough coding
When you code, it is also important to account for every applicable service. Not being specific enough can also create problems.
“The biggest mistake I have made is not coding enough,” said Scott Schreiber, DC of Delaware Back Pain and Sports Rehabilitation Center in Newark, DE. “At times, I wanted to ‘fly under the radar,’ but by doing this, I did not get paid for the services that I performed.”
Providing enough detail is in your best interest. Take specific notes and code for every service you actually performed, whenever possible. Even very small billing discrepancies may add up over time to a significant loss if your clinic creates a pattern of under-billing. Since you may not always receive full reimbursement, you may want to avoid billing too little intentionally.
Invest in training
“When I graduated, I knew very little in terms of coding and documentation, so I made a ton of mistakes,” Schreiber said. “I started my self-education by purchasing the ACA coding manual. I read it cover to cover several times. This is where I started to understand how documentation and coding were interrelated and how to properly code.”
From there, Schreiber says he began attending seminars and reading regularly about coding and documentation issues and strategies. Staying up-to-date with coding is vitally important and well-worth the effort, Schreiber believes.
If you have office staff involved in coding, you may want to encourage them to take an active interest in staying informed as well. Providing access to seminars or even finding freely available information and sharing it with your staff and coworkers may help reduce errors by encouraging knowledgeable coding.
Invest in prevention
Preventing costly mistakes should be a high priority for every chiropractic office. With these strategies, you may be able to minimize errors and avoid the possible consequences.