That’s Just “Sick”

Kathy Mills Chang, MCS-P, CCPC

At one point, the idea of chiropractic diagnosis was somewhat controversial. In fact, it’s said that, when pressed for a diagnosis, BJ Palmer himself would only describe a patient as “sick.”
But BJ Palmer didn’t have to submit claims to Medicare or other third-party payers, and he didn’t have to work with codes, let alone ICD-10.

Very few doctors I talk to consider ICD-10 a wonderful thing. It’s certainly been a huge transition, and the biggest “adjustment” to chiropractic healthcare since most of them got their degrees.
But here’s the thing: ICD-10 offers us a chance to step out of the simple language of symptomology and into the more specific language that clearly describes a patient’s condition. With that full vocabulary of coding available to us, we’re no longer limited to the small subset of care labeled “pain/symptom relief.” We’re able, now, to step up as physicians who diagnose, treat, and are reimbursed for that treatment.

How will that impact your practice and your revenue? If you master ICD-10 coding, the answer is, you should see a much more robust bottom line.

As DCs, we came to rely on “lower-level” symptom codes. But over-reliance on symptomology will only limit the care available for third-party reimbursement. After all, medical necessity can’t be justified for long unless you can support your care with clinical findings. And those clinical findings will need—you guessed it—diagnosis codes.

Happily ICD-10 offers us diagnosis codes a-plenty, with the kind of detail and specificity unlike anything we’ve ever seen. We can now distinguish not only between a sprain and a strain, but also specify laterality and even mechanism of injury. The more clearly we paint a detailed clinical picture for insurers, the more likely we are to get paid.

Using symptomology as a crutch will not only be detrimental to your practice’s bottom line – you simply can’t collect as much based on coding symptoms alone – it will also negatively impact the chiropractic profession. We know we offer much more than pain relief, or temporary alleviation of symptoms. ICD-10, finally, gives us the chance to prove it.

Don’t miss out on your chance to step up your game, and elevate your practice and your profession to a whole new level. Yes, ICD-10 is more complicated, more confusing, and just plain, well, more. But if you do it right, that “more” translates to increased revenue and decreased risk.

Kathy Mills Chang is a Certified Medical Compliance Specialist (MCS-P) and Certified Chiropractic Professional Coder (CCPC), and since 1983, has been providing chiropractors with reimbursement and compliance training, advice, and tools to improve the financial performance of their practices. Kathy leads a team of 15 at KMC University, and is known as one of our profession’s foremost experts on Medicare. She or any of her team members can be reached at (855) 832-6562 or info@KMCUniversity.com.