General

Does 98941 need a modifier?

Does 98941 need a modifier?

When providing maintenance therapy, no modifier is required when billing procedure codes 98940, 98941, or 98942. The AT modifier must not be placed on the claim when maintenance therapy has been provided. Claims without the AT modifier will be considered as maintenance therapy and denied.

What is the description of CPT code 98941?

CPT Code 98941 Chiropractic manipulative treatment (CMT); Spinal, 3-4 regions.

What is the AT modifier?

The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation. Medicare does not pay for maintenance therapy.

Is 98941 covered by Medicare?

Other Policies and Guidelines may apply. Diagnosis Code Description Medicare Covered Chiropractic Services If the CPT code is 98940, 98941, or 98942 and is billed with one of the following primary diagnosis codes and with modifier AT, then the chiropractic service is covered.

What is a 59 modifier chiropractic?

Modifier 59 is utilized to show an important, separately recognizable non-E/M service by the same physician on the same day. Manual Therapy Techniques (97140) used by chiropractors is a common example of a non-E/M service.

Can a chiropractor use GP modifier?

GP is the most appropriate for chiropractic claims, as it aligns with the therapy provider “physical therapy”.

What modifiers are used for chiropractic billing?

A. Chiropractic modifiers can be attached to certain CPT codes to tell insurance companies that there is something different about the services related to the CPT code being billed. While there are several modifiers, the two most commonly used in modifiers by chiropractors are modifier 25 and modifier 59.

What is an AT modifier in medical billing?

What is the AT modifier for chiropractic billing?

The Active Treatment (AT) Modifier Claims should contain a primary diagnosis of subluxation and a secondary diagnosis that replicates the neuromusculoskeletal condition of the patient. These are some of the commonly used modifiers in chiropractic billing.

What is XS modifier?

Modifiers 59 or –XS are for surgical procedures, non-surgical therapeutic procedures, or diagnostic. procedures that: • Are performed at different anatomic sites, • Aren’t ordinarily performed or encountered on the same day, and.

Can chiropractors use GP modifier?

What does modifier GP stand for?

Modifier GP: Services delivered under an outpatient physical therapy plan of care.

Can a chiropractor bill a GP modifier?

GP is the most appropriate for chiropractic claims, as it aligns with the therapy provider “physical therapy”. This does not mean Medicare is paying chiropractic providers for therapy; however, GP is a necessary modifier to assure a proper denial for a secondary payer to make payment.

Is AT modifier only for Medicare?

The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation.

How do you know when to use a modifier in CPT?

CPT modifiers (also referred to as Level I modifiers) are used to supplement the information or adjust care descriptions to provide extra details concerning a procedure or service provided by a physician. Code modifiers help further describe a procedure code without changing its definition.

What is the difference between modifier Xu and Xs?

Modifier XS Separate structure – A service that is distinct because it was performed on a separate organ/structure. Modifier XU Unusual non-overlapping service – The use of a service that is distinct because it does not overlap usual components of the main service.

When should I use modifier XS?

The use of modifier 59 or -XS is appropriate for different anatomic sites during the same encounter only when procedures (which aren’t ordinarily performed or encountered on the same day) are performed on different organs, or different anatomic regions, or in limited situations on different, non-contiguous lesions in …