Chiropractic Claim Coding Helper
Takes the doctor's visit notes and your office's own code list and builds a claim worksheet for the visit.
Before and after
CLAIM WORKSHEET
Patient: Chen Foster
Date of service: March 12
Provider: Dr. Cheryl Fuller
Office: Olivemere Chiropractic, 7423 Lynnmere St, Brightgate, 312-555-0180
Prepared for: Christian Glover
Line 1: 98941 (CMT 3-4 regions)
- Documented: adjusted C5 (cervical), T4 (thoracic), L5 (lumbar), SI left (sacral). That is 4 regions.
- Units: 1
- Suggested diagnosis link: M99.01, M99.02, M99.03, M99.04 (suggested, doctor to confirm)
- Fee: $62
Line 2: 97014 (e-stim unattended)
- Documented: 15 min, low back
- Units: 1
- Suggested diagnosis link: M54.50 (suggested, doctor to confirm)
- Fee: $24
Line 3: 97110 (therex per unit)
- Documented: core stabilization, 10 min, one on one with the doctor
- Units: 1, based on your payer sheet rule of at least 8 min per unit
- Suggested diagnosis link: M54.50 (suggested, doctor to confirm)
- Fee: $38
Line 4: 97140 (manual therapy per unit)
- Documented: trigger point work, upper traps, 8 min
- Units: 1, based on your payer sheet rule of at least 8 min per unit
- Suggested diagnosis link: M54.2 (suggested, doctor to confirm)
- Fee: $36
Diagnoses as documented by the doctor: M54.2 cervicalgia, M54.50 low back pain, M99.01 segmental dysfunction cervical, M99.02 thoracic, M99.03 lumbar, M99.04 sacral.
Total fees: $62 + $24 + $38 + $36 = $160
Ready or not: Almost ready. Please resolve the questions below first.
Questions for the owner
- Dr. Fuller, please confirm the diagnosis links on all four lines. The notes list the diagnoses but do not say which one goes with which service.
- Manual therapy was done on the upper traps and an adjustment was done in the cervical region on the same visit. Please ask Christian whether this payer needs a modifier or any extra note on the claim when these are billed together. I did not add one.
- Timed minutes are 10 for therex and 8 for manual therapy, 18 total. The manual therapy time is right at the 8 minute line on your payer sheet. We recommend Dr. Fuller confirm 8 minutes is the actual documented time.
- The notes do not list which core exercises were done. Does the chart note have them?
- Please confirm the final code selection with Dr. Fuller or your certified coder before submitting.
What it does
Takes the doctor's visit notes and your office's own code list and builds a claim worksheet for the visit. It lines up each documented adjustment and modality with a code, units, and a diagnosis link, and flags anything missing before the claim goes out. It does not decide codes on its own. The doctor or your biller makes the final call.
Use it when: Use when a chiropractic office needs to turn visit notes into a claim coding worksheet for adjustments and modalities, such as "code this visit," "get this ready to bill," "match the notes to our codes," or "check this superbill before it goes out."