Importance of Accurate Documentation for Insurance
It has been brought to our attention that quite a few people who are utilizing the Therapeutic Wobble Chair for patient care are instructing the patients to use the chair in their office for the first several visits, but not following up with documentation after the initial visits and still charging for said services.
Please be informed that while employing the Pettibon System in your clinic, you must document what you are doing with the patient and the patient’s response to care. I have seen many disciplinary issues while serving on the Chiropractic Quality Assurance Commission lately involving providers billing for said services and not having the proper documentation to back up their billings. If the patient’s insurance denies the services, the provider is liable.
There was one case that involved 125 recorded cervical traction and wobble chair maneuvers that were performed in the office over a six month period. The patient recalled using the equipment exactly 20 times. The charting was inaccurate, and the doctor wonders why they aren’t being reimbursed. This is the kind of nonsense that is ridiculous, with any health care provider, especially with one who is correcting the spine.
Please do your part and take care of patients, always documenting such. We cannot control your practice, but would like to save you possible duress, and would like to preserve the integrity of chiropractic as a whole.
Dr. Michael Milasich, D.C. – Tacoma WA
Board Member, WA Chiropractic Quality Assurance Commission
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What are the currrent DME codes for the Pettibon Rehab equipment?
I was told that Pettibon does not stay current on this and was shocked. Does anyone know or have an explaination?
The Pettibon System as a company does not do medical billing of product. Our understanding is that the codes can vary amongst the different providers and we rely on our doctors sharing new codes or changes to codes. It is an area that we are looking into becoming better versed in for 2011. As far as we know the DME codes for Pettibon Rehab equipment are as follows:
Durable Medical Equipment:
a. Cervical Traction Unit – E0855 or E0860
b. “Positioning Cushion/Wedge” – E0190
c. Other equipment: We use E1399 which is “miscellaneous DME”. When using this code it may be important to use the product catalog and letter of medical necessity. This does not have to be long and drawn out. Simply state the patient’s problem that will be addressed with the specific equipment. You can also send a copy of the page from the Pettibon catalog as a description of the equipment.
These are ONLY recommendations, codes change without notice. Please share any other trends you begin to experience, as we discover more, we will gladly share them.
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