RE: auto injury solutions

[Guest guest]

If you are distinctly in the shoulder region, and not overlapping the C-spine, it should be considered a separate region. Do you have a separate diagnosis for the shoulder region that is related to the original injury? 97140 has two criteria to be met when billed with CMT; first it must be submitted with modifier 59 as a distinct and separate procedure and secondly, it must be performed to a region where manipulation has NOT been used. I did not define, I simply report information.

Massage, CPT 97124, does not have this same prohibition, so you might try this code since myofascial release can be defined as a variation of massage.

97140 is a nightmare code that was created in 1999. While it definition has been clarified over the years, it has done nothing more than cause confusion in chiropractic practice.

Tom Freedland

In a message dated 2/27/2008 2:08:20 P.M. Pacific Standard Time, lauren_mccabe@... writes:

Is anyone else having problems with Auto Injury Solutions? They process claims for Safeco insurance. We have gotten denials from them for providing myofascial release to the shoulder girdle on the same day as a cervical adjustment. Their argument is that the origin of some of the shoulder muscles is in the cervical region and therefore this work is part of the cervical adjustment. This doesn't seem right and I am trying to find out if this is just happening in our office. Thanks! McCabe, DC Delicious ideas to please the pickiest eaters. Watch the video on AOL Living.

[Guest guest]

probably the old 97140 crap. Key word: REGION. That allows them to use this "logic to deny payment".

ph Medlin D.C.Spine Tree Chiropracticwww.spinetreepdx.com

auto injury solutions

Is anyone else having problems with Auto Injury Solutions? They process claims for Safeco insurance. We have gotten denials from them for providing myofascial release to the shoulder girdle on the same day as a cervical adjustment. Their argument is that the origin of some of the shoulder muscles is in the cervical region and therefore this work is part of the cervical adjustment. This doesn't seem right and I am trying to find out if this is just happening in our office. Thanks! McCabe, DC

[Guest guest]

Safeco has just become a pain to work with period as of late. They will cause havoc no matter what you do. Do your best to handle there insanity.

Will Schneider

PDX

On Wed 27/02/08 10:07 PM , "lauren_mccabe" lauren_mccabe@... sent:

Is anyone else having problems with Auto Injury Solutions? They

process claims for Safeco insurance. We have gotten denials from them

for providing myofascial release to the shoulder girdle on the same day

as a cervical adjustment. Their argument is that the origin of some of

the shoulder muscles is in the cervical region and therefore this work

is part of the cervical adjustment. This doesn't seem right and I am

trying to find out if this is just happening in our office. Thanks!

McCabe, DC

[Guest guest]

Hi

If your documentation was adequate to separate the two areas of injury and

they still deny, I think you have reason to complain to the Ins Commission

in Salem.

If so, wait until the claim is near end.

Bob

W. Pfeiffer, DC, DABCO

P. O. Box 606

Pendleton Or 97801

541-276-2550

auto injury solutions

Is anyone else having problems with Auto Injury Solutions? They

process claims for Safeco insurance. We have gotten denials from them

for providing myofascial release to the shoulder girdle on the same day

as a cervical adjustment. Their argument is that the origin of some of

the shoulder muscles is in the cervical region and therefore this work

is part of the cervical adjustment. This doesn't seem right and I am

trying to find out if this is just happening in our office. Thanks!

McCabe, DC

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