Re: Noridian Medicare code question

[Guest guest]

Haven't seen it. Are you using 739.1,2,3,, etc.... or are you using subluxation 800 series codes in your diagnosis?? Seems like that would be where the specificity issue comes in.

Don White, RN, DC

In a message dated 1/6/2012 11:31:01 A.M. Pacific Standard Time, neroco2@... writes:

Greetings:Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB?I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0.Solutions?Thanks.Neil R. Cohen, D.C.Dundee Chiropractic

[Guest guest]

Neil, That code means your DIAGNOSTIC CODE doesn't have enough numbers in it. 739.1 is ok if there are no further numbers to add, but if there are, they want more to the 5th digit. Ann Goldeen On Fri, Jan 6, 2012 at 11:30 AM, neroco2@... wrote: Greetings: Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB? I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0. Solutions? Thanks. Neil R. Cohen, D.C. Dundee Chiropractic ___________________________________

[Guest guest]

Neil, That code means your DIAGNOSTIC CODE doesn't have enough numbers in it. 739.1 is ok if there are no further numbers to add, but if there are, they want more to the 5th digit. Ann Goldeen On Fri, Jan 6, 2012 at 11:30 AM, neroco2@... wrote: Greetings: Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB? I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0. Solutions? Thanks. Neil R. Cohen, D.C. Dundee Chiropractic ___________________________________

[Guest guest]

Ann is correct. The M code refers to the diagnosis code and in our case the subluxation code. On a few occassions I have received the same denial despite coding to the most specific level. A phone call to the provider center usually solves the problem quickly and the folks there are nice folks (in my experience thus far). If anyone is interested I can point them to the web location where Noridian spells out the diagnosis codes that are reimbursable and the treatment codes that are accepted for payment (of course we all know that is limited to the spinal manipulation codes).

J. Holzapfel, DCAlbany, Oregon

---------- Original Message ----------From: anngoldeen@...To: neroco2@...Cc: Subject: RE: Noridian Medicare code questionDate: Sat, 7 Jan 2012 00:24:20 -0500 (EST)

Neil, That code means your DIAGNOSTIC CODE doesn't have enough numbers in it. 739.1 is ok if there are no further numbers to add, but if there are, they want more to the 5th digit. Ann Goldeen

On Fri, Jan 6, 2012 at 11:30 AM, neroco2@... wrote:

Greetings:

Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB?

I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0.

Solutions?

Thanks.

Neil R. Cohen, D.C.

Dundee Chiropractic

___________________________________

[Guest guest]

Ann is correct. The M code refers to the diagnosis code and in our case the subluxation code. On a few occassions I have received the same denial despite coding to the most specific level. A phone call to the provider center usually solves the problem quickly and the folks there are nice folks (in my experience thus far). If anyone is interested I can point them to the web location where Noridian spells out the diagnosis codes that are reimbursable and the treatment codes that are accepted for payment (of course we all know that is limited to the spinal manipulation codes).

J. Holzapfel, DCAlbany, Oregon

---------- Original Message ----------From: anngoldeen@...To: neroco2@...Cc: Subject: RE: Noridian Medicare code questionDate: Sat, 7 Jan 2012 00:24:20 -0500 (EST)

Neil, That code means your DIAGNOSTIC CODE doesn't have enough numbers in it. 739.1 is ok if there are no further numbers to add, but if there are, they want more to the 5th digit. Ann Goldeen

On Fri, Jan 6, 2012 at 11:30 AM, neroco2@... wrote:

Greetings:

Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB?

I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0.

Solutions?

Thanks.

Neil R. Cohen, D.C.

Dundee Chiropractic

___________________________________

[Guest guest]

Okey doke...

http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=23711 & ContrId=35 & ver=15 & ContrVer=1 & CntrctrSelected=35*1 & Cntrctr=35 & name=Noridian+Administrative+Services%2c+LLC+(00821%2c+r) & CntrctrType=r & s=1 & bc=BBAAAAIAAAAA & Give this a try. It is in PDF format so if you are unsuccessful I can forward the PDF document.

J. Holzapfel, DCAlbany, Oregon

----- RE: Noridian Medicare code questionDate: Mon, 9 Jan 2012 21:25:59 -0800 (PST)

sure send it to me, thanks

Greetings:

Anyone getting the code M81 (You are required to code to the highest level of specificity) on the Noridian EOB?

I use the code 98940 AT for spinal manipulation for my medicare patients. Now Noridian sends me this code and pays 0.

Solutions?

Thanks.

Neil R. Cohen, D.C.

Dundee Chiropractic

___________________________________