There are two main ways to document the difference between medically necessary care and wellness care. The typical way of doing this is to simply ad a modifier.
Let’s say you’re using a 98940 code. If you put an AT modifier on it, that means its medically necessary care.
If you put a GA modifier on the code, it identifies the treatment as wellness.
Another option effectively used when a patient moves from medically necessary to wellness care is to use an S code. The adjustment code for a wellness adjustment is S8990.
Using a different code such as this, does afford you the opportunity to legitimately adjust your pricing. Another interesting and useful part of an S code is that you don’t have to have just one.
You can create multiple S codes, both in the adjustment and in the therapy category. The S code is a handy methodology to designate the difference between medically necessary adjustments and wellness adjustments.
However, I would recommend utilizing the services of a healthcare attorney before implementing various alternate codes or pricing, in order to ensure you remain compliant with both state and federal laws.
To view this blog as a video click this link – Chiropractic Coding for Wellness Treatment or Medically Necessary Treatment video.
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