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No Surprises

NEW COURSE! | Be Compliant with the No Surprises Act

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There's no need to fear the OIG. We've got your back!

The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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Need more guided help? Work with a KMC coach 1-on-1

Sometimes you need more than a self-service, on-demand program and need an expert to analyze your issues, train the corrections, and help you implement the changes, so they stick

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FX Modifier Required for Plain Films

Have you heard of the FX modifier?

On January 1, 2017, the Centers for Medicare and Medicaid Services (CMS) implemented the required use of this modifier when radiology services are provided via plain film, vs. digital. For example, when two views of the cervical spine are taken, the modifier is appended to the x-ray code, like this 72040-FX. The modifier is a pricing modifier, which means a reduction of 20% off the technical component of the films if plain films are taken. If you take digital films, no change to coding is necessary, as this reduction doesn’t apply.

But Medicare doesn’t reimburse for x-rays when ordered or taken by chiropractors

If a Medicare beneficiary asks you to submit your bill for x-rays, you must include the FX modifier if the x-rays were taken on plain films. Of course, Medicare doesn’t reimburse for x-rays when ordered or taken by chiropractors, but as the saying goes: As Medicare goes, so goes the nation.

Effective June 1, 2017, Aetna requires an FX Modifier when billing plain film x-rays. Other carriers will likely follow suit.

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...Not only is the Library impressive, but our one-on-one coaching with our Subject Matter Expert, Jill, was what really got us through this process. Jill got us set up with a portal to organize our work and keep us on task, coached us via phone call to discover any risks and resolve them, and continued to meet with us until all our assignments were completed. We still have some things to finish up throughout the remainder of the year, but Jill expertly trained us so that we can stand on our own from here and complete the process ourselves. To me, the ability to feel confident enough in this process to continue on my own is the most valuable thing, and Jill and KMC have provided us with that ability...

Neomi Hunt, M.S.