Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 We have been receiving denials from work comp carriers for massage services provided to active claims. Is this a coding problem on our side, or is there a new rule that disallows massage at the same clinic on the same day as a CMT such as 98940? Our massage services are provided by a LMT, but billed under the Chiropractic Clinic TIN. We are also seeing denials from PIP carriers for 97140 and 98940 on the same day. In another twist of events, State Farm is down coding a 98941 to 98940 if there are not three spinal areas listed for diagnosis. So if you adjust two lumbar segments and two cervical segments, you can only bill a 98940. an example of a down code was a case where full spine adjustments were given, but only a cervical and lumbar diagnosis was on that HCFA form. Obviously we provided typed chart notes showing all levels adjusted. Any comments? Ron Johansen DC Portland Quote Link to comment Share on other sites More sharing options...
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