Re: Car crash, no injuries

[Guest guest]

Matt, I would just use a good level E/M code. Depending on the time

you spent, and the complexity of the exam. If you spent a lot more

time than usual, use the extra time code that we learned about in

the coding class at the state convention. It goes above and beyond

the E/M code based on time only, so you might bill a lesser E/M code

because it is a fairly easy, non-complex case, but you may have

spent a lot of time with him. I don't have that code with me at

home, but if you email me on Monday, I will get it for your. We use

this code more lately with elderly, or people with young children,

or those that have language difficulties to make up for the extra

time we spend in the room above and beyond a normal exam/history

taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant

crash, because his wife made him. He had no

complaints, and I was not able to find anything wrong

with him either. I would like to bill his insurance

for the exam, what would be a good diagnosis code or

codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DCAuthor of Winning at Aging www.winningataging.com Wellness Chiropractor and Health Coachwww.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time

you spent, and the complexity of the exam. If you spent a lot more

time than usual, use the extra time code that we learned about in

the coding class at the state convention. It goes above and beyond

the E/M code based on time only, so you might bill a lesser E/M code

because it is a fairly easy, non-complex case, but you may have

spent a lot of time with him. I don't have that code with me at

home, but if you email me on Monday, I will get it for your. We use

this code more lately with elderly, or people with young children,

or those that have language difficulties to make up for the extra

time we spend in the room above and beyond a normal exam/history

taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant

crash, because his wife made him. He had no

complaints, and I was not able to find anything wrong

with him either. I would like to bill his insurance

for the exam, what would be a good diagnosis code or

codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

So: doesn't that leave the e/m code Ron was speaking of? You did the exam and the time, the fact that you didn't find anything doesn't preclude the action, does it? SunnySunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: mochihchu@...; oregondcs To: rongrice@...From: drjohnkalb@...Date: Sat, 28 Apr 2012 07:48:25 -0700Subject: Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DCAuthor of Winning at Aging www.winningataging.com Wellness Chiropractor and Health Coachwww.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time

you spent, and the complexity of the exam. If you spent a lot more

time than usual, use the extra time code that we learned about in

the coding class at the state convention. It goes above and beyond

the E/M code based on time only, so you might bill a lesser E/M code

because it is a fairly easy, non-complex case, but you may have

spent a lot of time with him. I don't have that code with me at

home, but if you email me on Monday, I will get it for your. We use

this code more lately with elderly, or people with young children,

or those that have language difficulties to make up for the extra

time we spend in the room above and beyond a normal exam/history

taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant

crash, because his wife made him. He had no

complaints, and I was not able to find anything wrong

with him either. I would like to bill his insurance

for the exam, what would be a good diagnosis code or

codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Not to be too cynical, but...I had this happen early on in my career. I sent in a bill without a Dx code and it got rejected. The claims examiner said, "no Dx code = no payment"! I spent way too much time, arguing with her, re-faxes chart notes and exam forms, I even wrote a letter explaining my argument. All to try and collect a $40 charge, All to no avail.Years later while retelling this story to a friend, who was a billing specialist at a hospital, she laughed and said, "NOTHING leaves the hospital without a Dx code!"Your best clinical opinion is that the patient has nothing wrong with him. That's fine, you may be clinically, scientifically and professionally correct, but if you bill that way, then plan on not get paid.However, the Dx code "847.x" does not include severity of the sprain. I think you could argue that even if one collagen fiber is disrupted you have a sprain. Therefore you can bill using 847.x. Odds are the examiner won't look at your chart notes they will just pay the bill. In your chart notes, under Assessment; describe the injury as "possible sub-clinical microsprain". Your treatment plan will be "no care recommended", so it's not like you are over-billing or trying to get extra treatments or pad the bill. Once I realized that the ICD-9 had Lumbago 724.2 as a diagnosis, when "low back pain" is not a diagnosis but a presenting symptom, then I realized that the use of the ICD-9 by the insurance industry has nothing to do with being clinically, scientifically and professionally correct. It has everything to do with playing their game to get paid. Too be clear, my chart notes represnt my best clinically, scientifically and professionally correct opinoin. I just don't get too excited about what code I use.Cynically Yours;Glenn Sykes, DCPortlandCC: oregondcs From: AboWoman@...Date: Sat, 28 Apr 2012 11:51:08 -0400Subject: Re: Car crash, no injuries

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Funny, well I'd go with E code describing the occurance in this case an MVA then how's about a "micro strain" 847.0.. And then when they deny have the patient hire one of the attorneys on the list threaten a PIP arbitration ...! Turn a negative into a positive and have some fun with it and put that claims representative on notice! Vern SaboeSent from my iPhone

Not to be too cynical, but...I had this happen early on in my career. I sent in a bill without a Dx code and it got rejected. The claims examiner said, "no Dx code = no payment"! I spent way too much time, arguing with her, re-faxes chart notes and exam forms, I even wrote a letter explaining my argument. All to try and collect a $40 charge, All to no avail.Years later while retelling this story to a friend, who was a billing specialist at a hospital, she laughed and said, "NOTHING leaves the hospital without a Dx code!"Your best clinical opinion is that the patient has nothing wrong with him. That's fine, you may be clinically, scientifically and professionally correct, but if you bill that way, then plan on not get paid.However, the Dx code "847.x" does not include severity of the sprain. I think you could argue that even if one collagen fiber is disrupted you have a sprain. Therefore you can bill using 847.x. Odds are the examiner won't look at your chart notes they will just pay the bill. In your chart notes, under Assessment; describe the injury as "possible sub-clinical microsprain". Your treatment plan will be "no care recommended", so it's not like you are over-billing or trying to get extra treatments or pad the bill. Once I realized that the ICD-9 had Lumbago 724.2 as a diagnosis, when "low back pain" is not a diagnosis but a presenting symptom, then I realized that the use of the ICD-9 by the insurance industry has nothing to do with being clinically, scientifically and professionally correct. It has everything to do with playing their game to get paid. Too be clear, my chart notes represnt my best clinically, scientifically and professionally correct opinoin. I just don't get too excited about what code I use.Cynically Yours;Glenn Sykes, DCPortlandCC: oregondcs From: AboWoman@...Date: Sat, 28 Apr 2012 11:51:08 -0400Subject: Re: Car crash, no injuries

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Wow Glen! That is exactly my philosophy! Great example and creative solution!

M Kalb MS DCAuthor of Winning at Aging www.winningataging.com Wellness Chiropractor and Health Coachwww.DrKalb.com

Not to be too cynical, but...I had this happen early on in my career. I sent in a bill without a Dx code and it got rejected. The claims examiner said, "no Dx code = no payment"! I spent way too much time, arguing with her, re-faxes chart notes and exam forms, I even wrote a letter explaining my argument. All to try and collect a $40 charge, All to no avail.Years later while retelling this story to a friend, who was a billing specialist at a hospital, she laughed and said, "NOTHING leaves the hospital without a Dx code!"Your best clinical opinion is that the patient has nothing wrong with him. That's fine, you may be clinically, scientifically and professionally correct, but if you bill that way, then plan on not get paid.However, the Dx code "847.x" does not include severity of the sprain. I think you could argue that even if one collagen fiber is disrupted you have a sprain. Therefore you can bill using 847.x. Odds are the examiner won't look at your chart notes they will just pay the bill. In your chart notes, under Assessment; describe the injury as "possible sub-clinical microsprain". Your treatment plan will be "no care recommended", so it's not like you are over-billing or trying to get extra treatments or pad the bill. Once I realized that the ICD-9 had Lumbago 724.2 as a diagnosis, when "low back pain" is not a diagnosis but a presenting symptom, then I realized that the use of the ICD-9 by the insurance industry has nothing to do with being clinically, scientifically and professionally correct. It has everything to do with playing their game to get paid. Too be clear, my chart notes represnt my best clinically, scientifically and professionally correct opinoin. I just don't get too excited about what code I use.Cynically Yours;Glenn Sykes, DCPortlandCC: oregondcs From: AboWoman@...Date: Sat, 28 Apr 2012 11:51:08 -0400Subject: Re: Car crash, no injuries

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Sitting in the San Diego airport waiting to come home. So to kill time I'll tell you a crash no injury story. Had a long time patient good guy with a fun sense of humor he walks into the clinic one summer day unannounced and says he has been in a car accident and wants to talk with the doc.So I duly have him sit in my private office as I finished with two patients. Once in the room he tells me, Hey doc I was sitting at a stop sign behind one of those huge garbage trucks when started to back very slowly I was trying to put my car in reverse and honk at the same time. Well he didn't hear me and I didn't move fast enough and he's truck just smashed in my hood...could I have been hurt doc???So I of course asked "well are you hurt? He said, "well I don't know that's why I came to see you!". Smiling I said, "well R..do you have any pain? "no," have you noticed any changes like stiffness or anything at all? "no," "Well you knucklehead a slow crush of you car is't going to cause injury it's the sudden acceleration (rear end) or decceleration (front end) that causes injury your not hurt get out of my office ya knucklehead!". And we both had a laugh!! Vern SaboeSent from my iPhone

Not to be too cynical, but...I had this happen early on in my career. I sent in a bill without a Dx code and it got rejected. The claims examiner said, "no Dx code = no payment"! I spent way too much time, arguing with her, re-faxes chart notes and exam forms, I even wrote a letter explaining my argument. All to try and collect a $40 charge, All to no avail.Years later while retelling this story to a friend, who was a billing specialist at a hospital, she laughed and said, "NOTHING leaves the hospital without a Dx code!"Your best clinical opinion is that the patient has nothing wrong with him. That's fine, you may be clinically, scientifically and professionally correct, but if you bill that way, then plan on not get paid.However, the Dx code "847.x" does not include severity of the sprain. I think you could argue that even if one collagen fiber is disrupted you have a sprain. Therefore you can bill using 847.x. Odds are the examiner won't look at your chart notes they will just pay the bill. In your chart notes, under Assessment; describe the injury as "possible sub-clinical microsprain". Your treatment plan will be "no care recommended", so it's not like you are over-billing or trying to get extra treatments or pad the bill. Once I realized that the ICD-9 had Lumbago 724.2 as a diagnosis, when "low back pain" is not a diagnosis but a presenting symptom, then I realized that the use of the ICD-9 by the insurance industry has nothing to do with being clinically, scientifically and professionally correct. It has everything to do with playing their game to get paid. Too be clear, my chart notes represnt my best clinically, scientifically and professionally correct opinoin. I just don't get too excited about what code I use.Cynically Yours;Glenn Sykes, DCPortlandCC: oregondcs From: AboWoman@...Date: Sat, 28 Apr 2012 11:51:08 -0400Subject: Re: Car crash, no injuries

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

If this were my patient, I would sit on the exam and ask him to

return in a week or two to re-evaluate. Injuries may show up "after

the fact" and I would not want to jeopardize the patients status by

reporting that nothing is wrong immediately after an accident.

Rod , DC

Tillamook

This guy came to me after a fairly significant

crash, because his wife made him. He had no

complaints, and I was not able to find anything wrong

with him either. I would like to bill his insurance

for the exam, what would be a good diagnosis code or

codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

No virus

found in this message.

Checked by AVG - www.avg.com

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04/27/12

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[Guest guest]

Yea, I have had that pointed out to me.  Sorry.  When I read code or

codes, I just jumped at CPT.  Too late at night I guess.  As far as

DX codes, not real sure. 

Ron

Ron - I think Matt is asking about what diagnostic

code to use on his bill! It is an unusual situation where the

patient is normal with no injuries - so how do you diagnose him?

With NO diagnosis no payment! This is the quandary I see for Matt

and his patirnt. I would think perhaps and "E" code except I

believe they imply and injury along with the mechanism of injury,

in this case only a potential injury. So I have no answer either!

M Kalb MS

DC

Author of Winning

at Aging 

www.winningataging.com 

Wellness Chiropractor and Health

Coach

www.DrKalb.com

 

 

Matt, I would just use a good level E/M code. 

Depending on the time you spent, and the

complexity of the exam.  If you spent a lot more

time than usual, use the extra time code that we

learned about in the coding class at the state

convention.  It goes above and beyond the E/M code

based on time only, so you might bill a lesser E/M

code because it is a fairly easy, non-complex

case, but you may have spent a lot of time with

him.  I don't have that code with me at home, but

if you email me on Monday, I will get it for

your.  We use this code more lately with elderly,

or people with young children, or those that have

language difficulties to make up for the extra

time we spend in the room above and beyond a

normal exam/history taking E/M code allowance.  

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

 

This guy came to me after a fairly

significant crash, because his wife made

him.  He had no complaints, and I was not

able to find anything wrong with him

either.  I would like to bill his

insurance for the exam, what would be a

good diagnosis code or codes to use?

Thanks,

Matt

 

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

[Guest guest]

Now that is the best idea I have heard so far.  nice job Rod.

Ron

 

If this were my patient, I would sit on the exam and ask

him to return in a week or two to re-evaluate. Injuries

may show up "after the fact" and I would not want to

jeopardize the patients status by reporting that nothing

is wrong immediately after an accident.

Rod , DC

Tillamook

 

This guy came to me after a fairly

significant crash, because his wife made him.  He

had no complaints, and I was not able to find

anything wrong with him either.  I would like to

bill his insurance for the exam, what would be a

good diagnosis code or codes to use?

Thanks,

Matt

 

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

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[Guest guest]

Yeah, If nothing was found initially, I'd sit on it for 2 weeks and watch it. skSunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com To: mochihchu@...CC: oregondcs From: rjacksondc@...Date: Sat, 28 Apr 2012 10:58:20 -0700Subject: Re: Car crash, no injuries

If this were my patient, I would sit on the exam and ask him to

return in a week or two to re-evaluate. Injuries may show up "after

the fact" and I would not want to jeopardize the patients status by

reporting that nothing is wrong immediately after an accident.

Rod , DC

Tillamook

This guy came to me after a fairly significant

crash, because his wife made him. He had no

complaints, and I was not able to find anything wrong

with him either. I would like to bill his insurance

for the exam, what would be a good diagnosis code or

codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com

No virus

found in this message.

Checked by AVG - www.avg.com

Version: 2012.0.2169 / Virus Database: 2411/4963 - Release Date:

04/27/12

[Guest guest]

At least you have him trained to come in and check it out! Good job ! skSunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7CEugene, Oregon, 97401541- 654-0850; Fx; 541- 654-0834www.drsunnykierstyn.com CC: oregondcs To: DocGlennDC@...From: vsaboe@...Date: Sat, 28 Apr 2012 10:17:41 -0700Subject: Re: Car crash, no injuries

Sitting in the San Diego airport waiting to come home. So to kill time I'll tell you a crash no injury story. Had a long time patient good guy with a fun sense of humor he walks into the clinic one summer day unannounced and says he has been in a car accident and wants to talk with the doc.So I duly have him sit in my private office as I finished with two patients. Once in the room he tells me, Hey doc I was sitting at a stop sign behind one of those huge garbage trucks when started to back very slowly I was trying to put my car in reverse and honk at the same time. Well he didn't hear me and I didn't move fast enough and he's truck just smashed in my hood...could I have been hurt doc???So I of course asked "well are you hurt? He said, "well I don't know that's why I came to see you!". Smiling I said, "well R..do you have any pain? "no," have you noticed any changes like stiffness or anything at all? "no," "Well you knucklehead a slow crush of you car is't going to cause injury it's the sudden acceleration (rear end) or decceleration (front end) that causes injury your not hurt get out of my office ya knucklehead!". And we both had a laugh!! Vern SaboeSent from my iPhone

Not to be too cynical, but...I had this happen early on in my career. I sent in a bill without a Dx code and it got rejected. The claims examiner said, "no Dx code = no payment"! I spent way too much time, arguing with her, re-faxes chart notes and exam forms, I even wrote a letter explaining my argument. All to try and collect a $40 charge, All to no avail.Years later while retelling this story to a friend, who was a billing specialist at a hospital, she laughed and said, "NOTHING leaves the hospital without a Dx code!"Your best clinical opinion is that the patient has nothing wrong with him. That's fine, you may be clinically, scientifically and professionally correct, but if you bill that way, then plan on not get paid.However, the Dx code "847.x" does not include severity of the sprain. I think you could argue that even if one collagen fiber is disrupted you have a sprain. Therefore you can bill using 847.x. Odds are the examiner won't look at your chart notes they will just pay the bill. In your chart notes, under Assessment; describe the injury as "possible sub-clinical microsprain". Your treatment plan will be "no care recommended", so it's not like you are over-billing or trying to get extra treatments or pad the bill. Once I realized that the ICD-9 had Lumbago 724.2 as a diagnosis, when "low back pain" is not a diagnosis but a presenting symptom, then I realized that the use of the ICD-9 by the insurance industry has nothing to do with being clinically, scientifically and professionally correct. It has everything to do with playing their game to get paid. Too be clear, my chart notes represnt my best clinically, scientifically and professionally correct opinoin. I just don't get too excited about what code I use.Cynically Yours;Glenn Sykes, DCPortlandCC: oregondcs From: AboWoman@...Date: Sat, 28 Apr 2012 11:51:08 -0400Subject: Re: Car crash, no injuries

There's a code for 'Motor Vehicle Accident' in the CPT/ICD code book. you can submit the bill for the exam, using that code and leave a diagnosis indicating 'within normal limits'. Exams to rule out injury following a significant accident should be compensated. I've submitted that before. I don't have the codes in front of me and only used them 2 times. But you can find them in your code book. Send all paper work with the billing.

Minga Guerrero DC

abowoman@...

Re: Car crash, no injuries

Ron - I think Matt is asking about what diagnostic code to use on his bill! It is an unusual situation where the patient is normal with no injuries - so how do you diagnose him? With NO diagnosis no payment! This is the quandary I see for Matt and his patirnt. I would think perhaps and "E" code except I believe they imply and injury along with the mechanism of injury, in this case only a potential injury. So I have no answer either!

M Kalb MS DC

Author of Winning at Aging

www.winningataging.com

Wellness Chiropractor and Health Coach

www.DrKalb.com

Matt, I would just use a good level E/M code. Depending on the time you spent, and the complexity of the exam. If you spent a lot more time than usual, use the extra time code that we learned about in the coding class at the state convention. It goes above and beyond the E/M code based on time only, so you might bill a lesser E/M code because it is a fairly easy, non-complex case, but you may have spent a lot of time with him. I don't have that code with me at home, but if you email me on Monday, I will get it for your. We use this code more lately with elderly, or people with young children, or those that have language difficulties to make up for the extra time we spend in the room above and beyond a normal exam/history taking E/M code allowance.

The Strategic Chiropractor class was great.

Ron Grice, DC

Albany, OR

This guy came to me after a fairly significant crash, because his wife made him. He had no complaints, and I was not able to find anything wrong with him either. I would like to bill his insurance for the exam, what would be a good diagnosis code or codes to use?

Thanks,

Matt

Dr. Matt Freedman

Chiropractic Physician

Pure Life Chiropractic, LLC

315 West Broadway

Suite 100

Eugene, Oregon 97401

(541) 343- 5633

http://www.EugeneChiropractic.com

http://www.EugeneHyperbaric.com