Edited: Gerald Stevens DC, MS, MPH

As Governor Cuomo delivered his State of the State addresses, one of the issues again highlighted was workers compensation reform. As you know, this impacts your patients and your practice. The NYSCA, working with the NY Chiropractic Council, has recently met with the WCB to welcome its new Chair and discuss the issues facing the chiropractic patient. NYSCA's WC Committee will continue to address the issues we face.

As some of you are aware, there are some changes coming to the Optum Health / UnitedHealthcare program which may impact your practice. The NYSCA Insurance Committee has responded to dozens of calls to assist our members in understanding these impending changes. A summation of our knowledge to date, as already conveyed to many of our members, has been posted in the members only section of NYSCA.com.  

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number on new Medicare cards for transactions like billing, eligibility status, and claim status.

What do you need to do to get ready?

There are thousands of code changes going into effect on October 1. Here is a list of the 70 or so that are most relevant to chiropractors. All of this information, and a whole lot more can be found in our brand new 2017 ICD-10 Coding for Chiropractic book. Order your ChiroCode book today and get a free cheat sheet!

The CERT program’s review of claims for chiropractic services has consistently yielded high improper payment rates. The majority of chiropractic services claims were the result of insufficient documentation, such as:

This Special Edition (SE) MLN Matters® article is intended for Chiropractors submitting claims to Medicare Administrative Contractors (MACs) for chiropractic services provided to Medicare beneficiaries. CMS is providing this article in order to provide education for chiropractic billers on accessing the correct resources for proper billing. This article is intended to be a comprehensive resource for chiropractic documentation and billing.

Attention NYSCA Members,

As many of you are aware the NYSCA Workers' Compensation Committee has been working with Broadspire and Sedgwick after issues were identified with inappropriate denials of Chiropractic Manipulative Therapy rendered within the recommendations of New York's Medical Treatment Guidelines.

News and Alerts NGS Medicare

On March 28, 2016 the NYS WCB hosted an informational webinar and feedback session regarding the web based Medical Portal they have been developing. It was attended by the NYSCA WC Committee. As you may know, this is part of the larger Business Process Reengineering Project that they have been undergoing and the NYSCA has been engaged in for several years.

The Centers for Medicare and Medicaid Services (CMS) recently published a series of three Special Edition educational articles for DCs submitting claims for services provided to Medicare beneficiaries. MLN Matters® articles SE1601, SE1602 and SE1603 provide guidance on improving billing and documentation of chiropractic services, increasing compliance with Medicare regulations and reducing the profession's claims error rate. Also available are ACA's related resources here.

Dear Colleagues:

In brief: