Dr. Stu:
Perfect, thank you.
Dr. Sam:
Yeah, G8731 is when that you're basically saying treatment is over, so before I would report that and a patient says they have zero pain, no I don't think that happens often, but let's say they do, you better check to make sure there's tenderness or something because otherwise Medicare will review that note and we both know Medicare [inaudible 00:21:28] if they see the patients at a zero, very likely to say, “We don't think this patient needs any further care.” Hence why, we have this code. I would just tell the doctors, implore them, if they're reporting as zero and they still think they need care, they're going to give me something more on the notes that indicate, well what is there, is there palpatory tenderness, is there reduction of range of motion. This is not only pain. Here's what we have, so G8731, most common, G8731, there is pain and remember that’s a 1 or G8731 when it's zero pain. What this means is that we're going to have the patient realize that this is probably going to be the most common, you're probably going to have a patient either with or without pain, but there can be other issues that come up. Here is the issue that comes up I think that some doctors have come into, the patient comes in and refuses to tell you their pain. I've had patients tell me that “I don't want you to tell me what you see.” I'm not going to even argue with them. I'm going to say, “Okay fine.” When the patient refuses, you record it by saying G8442, so if the patient says, “I don't want to tell you” or realistically what if the patient is in such physical incapacity that they can tell you or that maybe it's such an urgent situation you just go right to treatment that's probably not typical for chiropractic, remember we use these not just for chiropractors but certainly don't be afraid if a patient refuses or just has an incapacity for it that day. You can report that also with G8442. Remember we just have to report these on 50%, so if we have this issue come up, this could get reported in between. You might have every visit recorded with 8730, but then because of a patient's refusal, there could be a visit in there with that G8442. There's another scenario that comes up, the patient comes in paint but you forget to write a treatment plan. Now, I doubt this may happen often, but nonetheless the patient comes in with pain, but they're ineligible because we can’t form a treatment plan. I don't think it's likely, but remember there's always these options [inaudible 00:23:19]. Technically G8939 means pain is positive, but no follow up plan due to patient ineligible or incapacity, maybe they're in such severe pain, you just send them out to emergency room. Again, not typical a chiropractic, but I will say possible, so next one. Sam, these are good points that you're raising and I don't know if everyone is grasping it as good and as much as they should because with the insurance audits that we get to see and I know you certainly get to see them all the time, we refer the doctors to you as well. A lot of the insurance audits, when it comes to Medicare, their error rate in chiropractic is astonishing. That's why we're having such problems as a profession with Medicare. Quite frankly, a lot of doctors don't even want to deal with Medicare, but it's these errors and the errors can be as simple as what you just reviewed, just not reporting properly, an error can be something as simple as not making sure you sign
Dr. Stu:
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