MMA - Expansion of Coverage for Chiropractic Services Demonstration
Beginning April 1, 2005 CMS is conducting a demonstration to evaluate the feasibility and advisability of expanding the coverage of diagnostic and other chiropractic services under Medicare. There is no requirement to enroll in the demonstration however there are geographic areas allocated for this demonstration project.
A chiropractor performing clinical lab tests, and any labs that chiropractors order tests from, must comply with the Clinical Laboratory Improvement Amendments (CLIA) program and the site must be CLIA certified. You will be required to include your practice site's CLIA certification number in :X12N837P (HIPAA version) loop 2300, REF02. REF01=X4.
Chiropractors must apply demonstration code 45 to all demonstration claims (Loop 2300 REF02(REF01=P4).You will be required to submit claims for demonstration services separately from claims for CPT codes 98940,98941,and 98942.
If you are using the PC-Ace software you will enter the demonstration code 45 on the extended/ patient/ general tab in the box described as Special Program Indicator.
Additional information regarding the demonstration can be found on the CMS web site at: http://www.cms.hhs.gov/DemoProjectsEvalRpts/
You may contact us if you have any questions or concerns.
EDI Hotline:
WI/IL/MI
877 567-7261
Minnesota
952 885-2811
952 885-2881
952 885-2882
