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Illinois Chiropractic Society Works with American Medical Association

Monday, December 3, 2018   (5 Comments)
Posted by: Marc Abla
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Illinois Chiropractic Society Works with American Medical Association

(Press Release)

 

(December 3, 2018 – Springfield, IL) - The Illinois Chiropractic Society (ICS) has been working with the American Medical Association (AMA) in 2018 to clarify problematic language published in 2007 in the CPT® Assistant. The ICS noted that the 2007 guidance was overly inclusive in the number and types of services bundled as part of chiropractic manipulative treatment (CMT).  We are happy to report that the AMA has recently revised this language to remove from the CMT narrative some of the elements that are more appropriately characterized as part of a patient re-evaluation.

An important change was to remove the suggestion that CMT includes the evaluation of new complaints and modification of the current treatment plan. In reality, both services are typically a part of a re-evaluation of a patient and require more extensive physician time and effort than would be a part of the more regular CMT.  In fact, insurers require that providers perform these distinct services at consistent intervals to demonstrate patient progress. However, we are aware that the original language in the 2007 CPT® Assistant article was being used to deny claims for these very services, creating a barrier to care for patients.

The process to improve the language included the AMA CPT® Assistant Editorial Board and a national chiropractic stakeholder group. These groups created the new language and appropriately removed the broad examination components and now contains more appropriate services specific to routine CMT. “These changes should assist doctors and patients overcome previous reimbursement challenges that used the 2007 language to reject appropriately billed services,” said Dr. Tim Bertelsman, ICS President. “Insurers should take note of the changes and aptly process claims, taking into consideration the new language.”

The ICS and AMA believe the new language is more appropriate to distinguish CMT from periodic evaluation services. The ICS applauds the AMA’s commitment to providing accurate and timely education on CPT codes.  

Founded in 1926 as a not-for-profit organization, the Illinois Chiropractic Society represents the chiropractic profession in Illinois and is acknowledged in the Illinois Medical Practice Act of 1987.  The Illinois Chiropractic Society is the unified voice for chiropractic in Illinois and a strong promoter of the chiropractic profession under the banner of "Natural First!"  The ICS is proud of its chiropractic physicians, who are valuable members of their patient’s health care team, serving as the natural first experts alongside other providers.  Should anyone have questions regarding chiropractic in Illinois, please visit www.ilchiro.org or call the ICS at (217) 525-1200.

 

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Comments...

Marc Abla CAE says...
Posted Thursday, December 6, 2018
Dr. Labelle, I have no idea. Although you could try, it may be difficult. Sorry.
Patrick D. Labelle DC CCSP FMS SFMA CKTP says...
Posted Thursday, December 6, 2018
Thanks Mark. That exact language would be great to include in appeals. Any ability to go retroactive?
Marc Abla CAE says...
Posted Tuesday, December 4, 2018
Dr. Ginsberg, Due to copyright restrictions, you would have to purchase the CPT Assistant for November 2018 and for 2007 (to see what it was previously and what has been used by BCBSIL for denials). We are working now with the AMA to find a way to legally distribute the language to our members, but that is still in process... hopefully soon.
David A. Ginsberg DC says...
Posted Tuesday, December 4, 2018
Where can we get a copy of the language that was updated to use with appeals against insurance companies?
David A. Ginsberg DC says...
Posted Tuesday, December 4, 2018
Where can we get a copy of the language that was updated to use with appeals against insurance companies?

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