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Chiropractic Insurance Billing Service

chiropractic-insurance-billing-service-woman-on-the-phoneFrequently Asked Questions About Chiropractic Billing

If you are new to dealing with chiropractic insurance billing services such as the services available from Genesis Chriopractic Software, you may have a lot of questions about chiropractic billing and that’s okay because we are here to help you.

What is chiropractic billing?

Chiropractic billing is the submission of insurance claims to insurance companies to ensure that your chiropractor is paid for the treatment services they have provided you. You can find a more in depth answer to what chiropractic billing service is by asking about your choice of chiropractic insurance billing service this question. Most often chiropractic billing is dealing with not only private insurance but also Medicare and Medicaid.

How do you bill chiropractic services?

Oftentimes chiropractic services are billed by using the software you are purchasing from the chiropractic’s insurance billing service. However, you should understand that chiropractic services have separate billing codes than most medical providers and they are limited to those billing codes.

What CPT codes can chiropractic treatments use to bill their services?

Chiropractic care services typically fall under three primary categories for CPT codes however many chiropractors only use category one codes. Category one CPT codes describe procedures performed by healthcare providers and some of the most common codes used by chiropractors are listed below.

  • CPT Code 98940 Chiropractic manipulative treatment (CMT); Spinal, 1-2 regions
  • CPT Code 98941 Chiropractic manipulative treatment (CMT); Spinal, 3-4 regions
  • CPT Code 98942 Chiropractic manipulative treatment (CMT); Spinal, 5 regions
  • CPT Code 98943 Chiropractic manipulative treatment (CMT); Extraspinal, 1 or more regions
  • PT Code 99203 – Initial Exam
  • CPT Code 97110 – Therapeutic Exercise

CPT codes are very integral to the chiropractic billing process because these codes told the insurance company what the chiropractor is doing and they would like to be inverse for this. Insurance companies use CPT code to track health data and ensure that something is not being over prescribed by a company or medical provider. Medical providers have access to a larger amount of CPT codes however chiropractors have a limited set, with four in total dealing with spinal manipulation.

The above list is still not a full list however it does have two of the most common chiropractic codes or physical therapy codes that chiropractors have access to, as well as the four coats dealing with spinal manipulations.

What are chiropractic modifier codes?

Chiropractic modifier codes are character modifiers that may be attached to codes to tell insurance companies that something different happened with that service related to the CPT code being billed. When a code requires a modifier but they are billed without when the insurance will reject it. You should talk to your chiropractic insurance billing service if you have any questions about how the bill chiropractic modifier codes.

Furthermore, while there are many modifiers to use, the two that are most commonly used by chiropractic caregivers are modifier 25 and modifier 59. Modifiers ensure maximum reimbursement, so ensure that you’re using them correctly and have a chiropractic insurance billing service that is set up to use them correctly for your business.