OIG Study Brings to Light Inappropriate Chiropractic Payments

CMS divulges the results of OIG’s recent audits of chiropractic claims – gets chiropractors thinking.

Chiropractor claims are in the OIG spotlight. The OIG’s study ‘Inappropriate Medicare Payments for Chiropractic Services’ shows that a major portion of the claims submitted by chiropractors for Medicare services were paid improperly, reports MLN Matters article SE1101

According to the MLN Matters article, the most common errors were technical mistakes such as missing signatures or dates of service in the record, inadequate documentation that all procedures reported were performed, and insufficient documentation to show that all procedures and services were medically necessary.

Better compliance & lower payment rate: “The goal of this article is to translate published Medicare coverage and payment requirements for chiropractic services into a few practical tips for better Medicare compliance and lower measured payment error rate,” says CMS in the article.

Prevent further scrutiny: Chiropractors should review clinical documentation and billing practices and see to it that office staff is well-informed about the correct use of codes and modifiers, as well as of Medicare coverage policies for chiropractic services, the article stresses.

More information is at www.cms.gov/MLNMattersArticles/downloads/SE1101.pdf