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Hey there everyone. This is Sam Collins, the coding and billing expert back at you again for another program with ChiroSecure. And guess what time it is? It’s code update time. Here’s a rule for when will the 2023 diagnosis begin? Every year diagnosis code don’t update January 1st. When do they update October 1st?
So that’s a short time away. What’s going on this year. What’s changing. What’s updating. Let’s make sure you’re up to date and let’s be careful of hyperbole. Let’s go to the slides, everyone. All right let’s talk about the 2023 diagnosis. IC 10. As you’re well aware codes do update every year. As I noted in October and some years there’s big changes and we’ve seen them there’s other years, not so much.
I always wanna be careful. I’m gonna be pretty centric when it comes to this. And let’s be careful. Do you need to buy a new code book? I think not, with online access HD Ross does a digital access. One. There’s lots of ways of getting codes. But remember when you go online is the person you’re getting them from.
Do they have the updated set? Do they have the current set? That is the ones that are the billable and quite frankly payable codes. So let’s talk about ICD 10, obviously ICD 10 is what we’re using. We have used for a while. I’ll let you know. The world is moving to I C, D 11 as we speak. And you’re going what I’m actually part of that committee, but don’t worry.
The us is not ready for that yet. We’re still using ICD 10. And remember that’s how we track evidence of claims. Billing and payment really is what I’m concerned with. If you’re not using the right code, we’re not getting paid. So let’s understand for chiropractic. What type of coding is. Chiropractors can treat the human condition.
In my opinion, coming from a chiropractic family, there’s lots of things you can treat. That’s not always gonna be covered by insurance. And I get that. However, let’s talk about where payment lies. And we’re the boards push us a little bit. And that is, and you’ll see here from Aetna, the member must have a neuromuscular skeletal disorder.
So when it comes to coding, those are the ones I’m most concerned with because those are the ones attached to reimbursement. And quite frankly, what patients are mostly gonna come for. So this is the Medicare protocol, or excuse me, the Aetna here’s of course Cigna, and you’ll see their policy. And again, I’m trying to show you the policies.
So it’s not just me saying it. Cause I think there’s too many people going. I’m the expert. I’m saying it. What’s your evidence. Here’s your. Aetna’s policy bulletin, Cigna’s policy bulletin. And I highlighted in blue the services aimed at a diagnosis and treatment of a musculoskeletal related disorder.
So we know we have to focus in on that. Even Medicare says the same thing while we want subluxation that’s musculoskeletal, but there needs to be a secondary condition. So we have to know there’s always gonna be updates. And this year is no different from the past six years. Every year, there’s an update some years, those updates are big, some not so big.
And so I’m always careful with hyperbole of people saying, you’ve gotta do something. You AB it by the new thing. We wanna make sure, what I care about, what happens for us. What changes for us? Let’s take a look at the past of what things have updated as you’re well aware last year was a big deal for us because there were three new codes for low back pain.
And of course everyone was, oh, wait, we gotta do. And of course the most common one’s still gonna be M 54 59, just not the M 54 5. Remember M 54 51 for low back pain is vertebro or end plate pain. Okay. So let’s be a little bit careful there on, on the use. And of course there’s cervical gen headache. That was a new.
So that was it though. Was there anything else that really made a major change? Not really. So when people say there’s a big change, would that be worth purchasing a brand new book? No. Just get access to where you get the information. That’s why with me today or glad you’re with me today, let’s look at what happened in 2021.
Remember the change there was the headache codes. And one thing I will point out. Sometimes you look at headache codes. This one says, orthostatic, this one says unspecified, but no, all the things that are unspecified headaches, including things like sinus and exci. So realize that’s a catch all for a little bit of everything, but again, it was a new code.
If you use our 51, it’s getting denied. And then every year there was updates, but notice in 2020, nothing here really updated. That was really any care for us in our profession. I Vertigo, eh, but not really. How about 2019? That was a big deal. Myalgia updated. Okay. We have to know there’s one for neck and 2018 spinal Sten.
And then 2017 is when we had the big update. Remember all the things for TMJ and for disk. Here’s what I’m highlighting. I’m showing all the changes and be careful. You’re gonna be inundated with advertising. You gotta get the new codes and be ready. Heck I’m doing an article. That’s gonna come out dynamic chiropractic about it as well.
But you’re the first to know that’s how much we love ChiroSecure of course, to understand what’s going on for us. This. To show the complete coding, the 2023 codes, which begin October 1st, just a few weeks away. There’s now 73,000 diagnosis. You’re like, wow. 73,000. Do we need to know that many, frankly?
No, I bet. Most of you’re probably coding the same 10 or 20 things. Maybe even less. All the time, because that’s what let’s not pretend we don’t see a lot of the same thing over and over. There’s 1100 new additions. Ooh. That seems like a lot deleted 287 with 28 revisions. But you know what I care about chiropractic.
So let’s be ChiroSecure centric when it comes to this. Yes. I could sit here and tell you, oh, there’s 1100 new codes. What if they have no pertinent to your practice, to the things you care for? Do we really care? And I’m not saying we wouldn’t wanna have maybe a little background knowledge, but a code that’s for something we don’t treat.
If there’s a code for nephrosis, that’s a change. Would that really matter for us? No, it wouldn’t. So let’s talk about what has changed. What has changed for this year? That’s I think gonna be of importance is lumbar and lumbo sacral disc. Now what you’re seeing here are the current codes for lumbar and Lumal sacral disc.
You notice the first code is for disc disorders with myelopathy. The next codes are for disc disorders with radi. Then we have of course disc disorders that are displacement. Let’s be careful. Displacement means movement, which you could say is herniation. If you wanna say bulging, it encompasses all of that.
Then of course we have degeneration. That’s a separate code and we have also one that’s a generic code. Notice this one, the other ones all have something specific myelopathy, radiculopathy, displacement degeneration, but then we have this. Disc disorder. That’s other, what do they mean by other? What does that really refer to?
What does other mean? Think of all the things that can go on with the disc, it’s more than those three things or four things that I mentioned before. What about calcification? So lots of times I’ll get people say, Hey Sam, I need a code for a disc where there is an annual. I’ll say there’s no specific code for that.
So therefore you would use other well, that is what’s updated for this year for 2023. Here are the new codes that will change for you for some specificity, for an annulus fibrous defect. Now you might say is that something we’re gonna see? Oh, you be. I’ve had those with MRIs or others that have come back with that and say, they’re trying to find a code for it.
There never has been one. So now what they did was give one code or several that are specific to a annualist fibrous defect, whether it’s in the lumbar spine and it’s small or large. Lubo sacro spine smaller, large. Now, is that a major update? Is that gonna be one like, oh my God, that I’m shaking cuz I, I, no, this is just an ad code.
So this code is available to you now or? It will be October 1st of course. But keep in mind, it would have to have some specificity. So is that a big change in a way, cuz it is a new code, but is it one that’s really gonna change the things you build commonly? I’m gonna say probably. So always say be careful when someone says major change, know that, okay, let’s look at what’s major for us.
What has also changed for this year is some new codes for muscle atrophy or muscle wasting, but specific to the spine. There’s always been a code for muscle atrophy, but it’s been very generic. It’s just an anywhere code and what they did for this year, meaning 2023 is they’ve added coats specifically for muscle wasting in the back.
Meaning the. Upper back, lower back or someplace else, not specified in the spine. I doubt I’d used the last one, but there the three. So is that one you might use? I think so. There could be times for a person with a chronic injury where they’re getting a lot of muscle wasting a stability and so forth.
So that could fit in that certainly will lend to a complication. So certainly are there some changes there? You bet. There are, those are gonna be the only two that I think are of any major importance to. Because what else is new for this year? There’s a new code for concussion, but this code for concussion is you don’t know how long they were unconscious, know, think of a person, had a concussion go, did you lose conscious?
And they go, ah, I think so, but I don’t know how long cuz currently what we have a code is for up to 30 minutes or over an hour or not. And they just said, you know what, why don’t we have a code that just allows us to say, we don’t know now, is that a major, probably change. I don’t think so because probably what you’re gonna be coding anyway, is post-concussion syndrome.
Nonetheless, a new code there. There’s also a new code for post viral fatigue syndrome. They’ve updated that. Now. Could that be a code? That would be something we might use as a complication? I think so what if you have a patient that is recovered from COVID, but has long COVID and they are having any type of chronic or any back issue, could that type of thing add to the patient’s complication or complicate the patient’s.
To an extent now, would I use that code on the claim form? I’m not so sure. I want it in the chart notes though. It’s like obesity. It’s like diabetes. We’re not treating it directly, but it’s complicating the recovery that might fit there. There’s also a lot of new codes for endometriosis. This is what I’m pointing out.
There’s about 50 new codes for endometriosis. Is that something we code regularly. So again, I want to be careful with you to not get you overly high oh, there’s new codes. I better buy a new book. If you have last year’s book, you add what I’ve given. I think you’re gonna be fine. In fact, what I would suggest is if you’re doing something with an annualist defect.
Sure. We’ve got that. Otherwise I don’t think there’s enough major change, but here’s a new code. Look at this one. My patients are not always broke. That sounds awful, But when they are I code and get this code Z 91, 1 90 patient’s noncompliance with other medical treatment and regimen due to financial hardship.
How many times have we all seen that? Now I’m pointing this out. That to me, this tells us this is a significant problem. Now, is it one we’d actually code? No, this would be more for a. Understanding of it. Does that change how we would treat? No, but what I wanna bring this up for is that obviously if they’ve created a code for this is an issue.
And think in your practice, what is a barrier to a patient getting care often it’s money. So think in your practice, yes. You can take some insurances. You can offer a slight clash discount. What about prepaid plans? That’s maybe for another time when I go with you, but those are some things to think of.
Practice is gonna survive and thrive, frankly, off of getting patients. And when someone’s having a financial hardship, how do we help them? Whether it’s gonna be payment over time, some discounting prepay plans, but do keep that in mind. Now this has been a good synopsis of what’s changed. So you’re thinking, oh, October 1st, are there gonna be any changes to the common codes you’ve used?
There are not unlike last year. No changes there. Do remember though, the new codes don’t begin until dates of service. October 1st. So I had someone last year that was billing a patient in late to mid-October, but the treatment was in September and they were using the new codes. Which of course didn’t happen until the date of service.
So do keep that in mind. We’re always gonna be here to support you for those of you who have our HJ Ross, digital coding. I wanna give you a little secret of how to find things. If you have our system and you can’t find something, go into the search bar and literally type this data in 10 dash 1 20 22, that will literally give you all the codes that updated for this.
And another secret is if you wanna look at any change for any year, just type the same thing with the date of that year, we’re always wanna make sure you have the best and most current code. Remember members. If you’re a member with us, you also get our coding. That gives you the common codes for chiropractic.
So you don’t have to search all over, but certainly this search here allows it to be a little easier and helpful. And don’t forget, go to our website for all the current news and updates. We have a blog that’s every week updating on things like post injuries, post personal injury, post settlement issues, how to deal with certain types of aspects.
Take a good look, something to look at weekly. What I want you to know is we’re always gonna be here to help HJ Ross Company. Is your partner along with ChiroSecure. We’re here to make sure you thrive. If you want to have an expert on your staff, it’ll cost you as little as less than a thousand a year, which also gives two seminars.
In addition to that, you can contact me daily and I do a monthly webinar seminar with you. And guess who gets the code update first, our network members. So everyone, you now have the updates. You’re ready. October 1st. No big deal. Let’s move forward. Let’s continue to be that good doctor to our patients.
And so next time, everyone. Thanks so much.