OIG Report: $76 Million in Questionable Medicare Payments for Chiropractic Services

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently analyzed Medicare paid claims for chiropractic services from 2013. A major finding: In 2013, $76 million in Medicare payments for chiropractic services were questionable, with Medicare inappropriately paying $21 million for chiropractic services that lacked a primary diagnosis covered […]

CMS Provides Clarification on the Use of Modifiers When Billing “Wrong Surgery on a Patient”

The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast which was intended to clarify the correct use of certain HCPCS modifiers, specifically when billing for wrong surgery on a patient. CMS discussed the HCPCS modifier -PC (Wrong Surgery on Patient), which was established in CR6405 (pdf), along with two […]

American Chiropractic Association Publishes New PQRS Reporting Resources

The American Chiropractic Association (ACA) has published several new resources intended to help doctors of chiropractic (DCs) with proper implementation of Medicare’s Physician Quality Reporting System (PQRS). Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a PQRS negative payment adjustment (pdf) beginning in 2015. […]