Chiropractic Billing Regulations and Compliance Update

The journey of chiropractic billing regulations and compliance is multifaceted, marked by ongoing updates and revisions. All such updates aim to improve transparency, accuracy, and ethical standards within the healthcare industry.

Over the years, regulatory bodies and insurance providers have introduced various changes, responding to shifts in healthcare policies, technological advancements, and emerging trends in chiropractic care. Initially, chiropractic billing operated relatively simply, with practitioners focusing on manual adjustments and essential documentation for insurance claims. However, as the healthcare sector evolved, so did the regulations governing chiropractic billing.

Therefore, the healthcare industry's chiropractic billing regulations and compliance update for 2024 encompasses several key changes and trends that directly impact chiropractic billing practices. Let's delve into each aspect:

Evaluation and Management Codes (E/M) Updates

The changes in E/M coding guidelines emphasize factors such as patient complexity, time spent, etc. This shift reflects a more nuanced understanding of patient care, acknowledging that the level of effort and complexity involved in chiropractic treatments can vary significantly depending on individual patient needs. Chiropractors must ensure that their billing accurately reflects the level of care provided, aligning with the updated E/M guidelines.

Points to Remember:

• Removal of history and physical exam as key components.
• Introduction of time-based coding for office visits.
• Focus on medical decision-making (MDM) as the key factor in code selection.
• Revision of code definitions and guidelines to align with current practice.

ICD-10-CM Changes

The introduction of 395 new codes and revisions to 22 existing codes in the 2024 ICD-10-CM includes the addition of a new subcategory (G43. E-) specifically for chronic migraine with aura. This update allows chiropractors to document and bill for conditions such as chronic migraines more accurately, ensuring compliance with the latest coding standards. Chiropractic billing processes must incorporate these new codes and revisions to capture patient diagnoses and provide reimbursement for services rendered accurately.

Points to Remember:

• Introduction of new codes for cervical, thoracic, and lumbar spinal stenosis (M48.02, M48.12, M48.22)
• Addition of codes for intervertebral disc degeneration in cervical and lumbar regions (M51.04, M51.14)
• Expansion of codes for cervical and lumbar disc displacement (M50.12, M51.37)
• Updates to codes for cervical, thoracic, and lumbar intervertebral disc disorders without myelopathy (M51.35, M51.36, M51.37)
• Revisions to codes for cervical and lumbar sprains and strains (S13.4XXA, S33.5XXA)
• Modifications to subluxation codes, including new descriptors and subcategories (M99.0, M99.1)
• Changes in coding for joint disorders, such as osteoarthritis of the spine (M19.07)

Medicare Physician Fee Schedule Adjustments

The final rule for the 2024 Medicare physician fee schedule, released by the Centers for Medicare & Medicaid Services (CMS), includes a reduction of the conversion factor by 3.4% to $32.74. This reduction in reimbursement rates underscores the importance of efficient billing practices and accurate documentation for chiropractic services, as practices may experience decreased revenue per patient encounter. Chiropractors must adapt their billing strategies to mitigate the impact of reimbursement rate reductions while maintaining compliance with Medicare billing regulations.

Points to Remember:

• Adjustments for practice non-facility practice expense RVUs.
• Reflects malpractice insurance costs.
• Discounts for Multiple Procedure Payment Reductions (MPPRs) services.
• Coding modifiers for specific conditions for Chiropractic services.
• Ensuring proper Correct Coding Initiative (CCI) practices.

Telehealth Billing Trends

Telehealth continues to be a significant trend in the healthcare sector, including chiropractic services. Chiropractors must stay abreast of telehealth billing guidelines to bill for remote consultations and treatments effectively. Compliance with telehealth billing regulations ensures that chiropractors can expand their reach and provide care to patients in remote or underserved areas while maintaining regulatory compliance.

Points to Remember:

• Choosing the right telehealth platform with secure communication and documentation features is essential for efficient billing and compliance.
• Educating patients about telehealth services, including billing processes and insurance coverage, can facilitate smooth interactions and payments.
• Integrating telehealth billing processes with electronic health record (EHR) systems.
• Chiropractors increasingly incorporate telehealth services into their practices due to patient demand and convenience.

Outsourcing for Compliance

Given the changing regulatory industry, outsourcing billing services to specialized companies, such as 24/7 Medical Billing Services, can help chiropractic practices navigate complex billing regulations and ensure compliance. Outsourcing allows practices to leverage expertise in billing and coding, reducing the risk of billing errors and potential non-compliance issues. Chiropractors should consider partnering with us, specialized as chiropractic billing company, to streamline revenue cycle management and maintain compliance with regulatory requirements.

Chiropractors must stay informed about these changes and implement strategies to adapt their billing practices accordingly. This will ensure accurate documentation, optimal reimbursement, and regulatory compliance. What are you waiting for? Reach out to the experts at 888-502-0537 to learn about the latest updates in chiropractic billing.

See also: Chiropractic Billing Outsourcing: A Custom Approach For Hospital Success