If a chiropractor submits a bill with a specific diagnosis and that bill comes back with a pre-existing clause and is denied, can the chiropractor re-submit the bill with new diagnosis codes as long as they apply?
Yes, chiropractors can absolutely re-submit bills. Often times you’re diagnosing several conditions, usually more than four conditions.
Now the CMS 1500 claim form only allows you four spots to put diagnoses on that claim form.
Many times you have many more diagnoses that you could put on the form, but due to limited space you can only put in the four.
So it’s not a problem to send in a replacement claim or a substitute claim if you think that a different diagnosis would apply and would actually overcome the denial and get the service paid.
The important thing to keep in mind is, “Is it truthful?” Does that diagnosis code actually apply to the services you provided?
If the answer is yes then go ahead, feel free to change the diagnosis code and re-submit.
To view this blog as a video click this link – Chiropractic Billing – Re-coding and Re-submitting Denied Claims video.
To view the rest of our video blogs relating to Chiropractic visit ClinicDr chiropractic youtube channel.
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