Compliance Today (March 2020)

In a recent report, Medicare Needs Better Controls To Prevent Fraud, Waste, and Abuse Related to Chiropractic Services (https://www.oig.hhs.gov/oas/reports/region9/91602042.asp), the Office of Inspector General (OIG) determined that payments for chiropractic services did not comply with Medicare billing requirements. Overall, medical record documentation did not support medical necessity or corrective treatment. CMS developed the Medicare Documentation Job Aid for Doctors of Chiropractic (PDF) (https://go.cms.gov/2FEieCu) MLN Educational Tool to help providers bill correctly.

Additional resources:

• Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and Subsequent Visits (PDF) MLN Matters article https://go.cms.gov/2uErO6b

• Use of the AT modifier for Chiropractic Billing (New Information Along with Information in MM3449) (PDF) MLN Matters article https://go.cms.gov/2TbzsPB

• Educational Resources to Assist Chiropractors with Medicare Billing (PDF) MLN Matters articlehttps://go.cms.gov/2shaKSU

• Medicare Needs Better Controls to Prevent Fraud, Waste, and Abuse Related to Chiropractic Services OIG Report https://bit.ly/2R6jJhX

• Medicare Benefit Policy Manual, Chapter 15 (PDF), Sections 30.5 and 240 https://go.cms.gov/37TcZe9

• Medicare Claims Processing Manual, Chapter 12 (PDF), Section 220 https://go.cms.gov/2t5fg7n

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