The American Chiropractic Association’s (ACA) Public Policy and Advocacy Department advocates for fair coverage and payment policies for the chiropractic profession.  The Department maintains an ongoing line of communication with a variety of insurers as a way to work through chiropractic-related insurance problems and to improve the communication between the profession and insurance industry. As well as monitoring state and nationwide insurance challenges, the Department responds to numerous requests for assistance from individual doctors of chiropractic.


ICD-10:  Are You Ready?

Transition to ICD-10 is underway with implementation taking effect on 10/1/2015.   ACA has created resources to help members with the transition to ICD-10, which include articles, timelines, FAQs, webinars, and a Toolkit complete with a mapping crosswalk. These resources on the ACA’s ICD-10 web page will be continuously updated as new information is released from government sites.  Also, check your quarterly In-Touch e-newsletter for in-depth articles and resources.

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Aetna Update: New Claims and Appeals  Resources 

ACA has been regularly updating members on its progress with Aetna regarding the processing of claims containing 97140-59 and CMT. Our most recent release stated that Aetna agreed to pay for 97140 when billed with CMT, if provided to a separate spinal region, and documentation for medical necessity was submitted with the claim. To assist members with filing these claims and appealing wrongful denials, ACA  has created a new webpage. 

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New HCPCS Modifiers 

On January 5, 2015, Medicare and private pay claims submission should start to include the use of the New 59 subset modifiers. There will be a grace period of introduction, but each office should be aware of the changes and start the implementation process as soon as possible.  These new subset modifiers were proposed by CMS in August to provide greater detail in outlining the specific need for where the 59 modifier should be used. 

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NUCC Updates 1500 Claim Form

On June 17, the National Uniform Claim Committee (NUCC) announced final approval of the Version 02/12 1500 Claim Form by the Office of Management and Budget. NUCC began revisions of the 1500 claim form in 2009 in order to accommodate reporting needs for ICD-10 and Version 5010. ACA has compiled additional information to help you better understand the change and to assist you in the transition. 

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Accountable Care Organizations

A new resource, “Accountable Care Organizations – What’s Next for DCs,” is now available to members who are interested in learning more about ACOs and how to affiliate with them. We encourage you to review this information and contact us with any questions and/or information you may have about ACOs being established in your state. ACA is also developing additional resources on this topic and will announce their availability via Week in Review in the near future.  

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Boy Scouts of America

ACA has been advocating for doctors of chiropractic to be able to perform annual evaluations on Scouts and Leaders since early 2009 when a change was made disallowing DCs from provision of these services. Additionally, ACA has created tools to help doctors, patients and members of the Scouting community voice opposition to this policy.

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