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Appealing CPT Code 99072
We have received many inquiries regarding how to best appeal denials of the new CPT code 99072 which was established to account for additional supplies and staff time needed due to a public health emergency. For more details on this code see our previous report...
Updated 2021 Medicare Fee Schedule
As the Consolidated Appropriations Act of 2021 (COVID Relief Bill) made changes to the 2021 Medicare Physicians' Fee Schedule, Medicare has released updated fees as of this morning. We have compiled the updated chiropractic specific codes for...
2021 Medicare Fee Schedule
2021 Medicare Fee ScheduleNOTE: The 2021 Medicare Fee Schedule has been updated, see article here. Medicare has released the 2021 Physicians Fee Schedule (PFS). We have compiled the chiropractic specific codes fee schedule for you here. We had previously...
Aetna -25 & -59 Modifier Claim Edits
If you recall, in early 2019 Aetna began blanketly denying codes with the -25 and -59 modifiers. After the ANJC took the matter to Aetna and the NJ Department of Banking and Insurance (DOBI), Aetna ceased the practice and reprocessed effected fully-funded...
HELP AVERT MEDICARE FEE SCHEDULE CUTS!
HELP AVERT MEDICARE FEE SCHEDULE CUTS!We had previously asked you to support the ACA’s effort to stop the cuts to Medicare reimbursement for chiropractic by contacting your legislator to support bill H.R.8505. New legislation, H.R.8702, the Holding Providers Harmless...
Aetna-NIA Update
Aetna’s pre-authorization vendor for in-network fully-funded insurance plans is making a change to their process. Effective Nov. 9, 2020 they will authorize care based on a total number of units per authorization period rather than by specific...
New CPT Code 99072 Review
In September, the AMA released a new CPT code, 99072, created to address additional expenses incurred by providers as a result of additional safety measures and cleaning supplies needed due to the COVID-19 pandemic.The formal definition of CPT 99072 is Additional...
2021 ICD-10 Code Updates
Each year on October 1st there are updates to the ICD-10 diagnosis code set implemented. Each year we advise you of any code additions or changes that affect chiropractic. Please note the codes below that are deleted and begin using their replacement codes as of...
Aetna Availity ERA/EOB Viewing Instructions
Some members have reported difficulties accessing their Aetna ERA/EOBs since Aetna's migration from Navinet to Availity. Members report having to enter all of their practice information and patient information each time they want to look up any patients claim or...
New Medicare ABN!
New Medicare ABN Medicare has released an updated Advance Beneficiary Notice (ABN) form. This new form will be mandatory as of August 31, 2020. An ABN is a written notice which a physician, provider, or supplier give to a Medicare beneficiary before items or services...