WELCOME TO THE PENNSYLVANIA CHIROPRACTIC ASSOCIATION!
YOUR PCA is working for you in Harrisburg and on Capitol Hill!
2022 ICD-10-CM Updates Effective October 1, 2021
Provided as a courtesy of the PCA
The 2022 ICD-10-CM files below contain information on the ICD-10-CM updates for FY 2022. These 2022 ICD-10-CM codes are to be used for discharges occurring from October 1, 2021 through September 30, 2022 and for patient encounters occurring from October 1, 2021 through September 30, 2022.
This year's coding updates that will affect chiropractic claims are listed below:
- M54.5 Low back pain. Loin pain and Lumbago NOS have been deleted from the description
- New Code: M54.50 Low back pain, unspecified. This includes Loin pain and Lumbago NOS.
- New Code: M54.51 Vertebrogenic low back pain, Low back vertebral endplate pain
- New Code: M54.59 Other low back pain
- M54.8 Other dorsalgia. Revise low back pain (M54.5) to low back pain (M54.5-)
- G44.86 Cervicogenic cephalgia (Code also the associated cervical spine condition, if known. Cervicogenic cephalgia is a secondary code.
*Be sure to send out all your billing up to September 30 due to the updated ICD10 codes above that go into effect on October 1*
Medicare ABN Changes
As previously stated in the communications sent to members in February 2021, which was also distributed to the Office of Governor Tom Wolf, PA General Assembly Members, and PA Congressional Delegation.
September 14, 2021
PCA Statement on Patient Choice
The Pennsylvania Chiropractic Association (PCA) supports the Pennsylvania health care consumers’ rights regarding their own health and well-being regardless of age, race, religion, creed, sex, sexual orientation, national origin, physical or mental challenges, or sources of payment.
The health and well-being of the health care consumer depends primarily on a collaborative effort between the patient and the health care provider. Therefore, all individuals have the right to receive understandable information about their diagnosis, treatment and prognosis, as well as the right to make informed decisions regarding their plan of care, course of treatment, and other important decisions for themselves and their families.
Since health care procedures and services often involve varying degrees of risk, it is essential that patients educate themselves with information about specific procedures and treatments and alternatives to existing treatments.
The Pennsylvania Chiropractic Association opposes mandated or compulsory medical procedures of any kind, as they infringe on the individual's ability to exercise the right to freedom of choice in personal health care decisions.
The Pennsylvania Chiropractic Association also supports other basic rights of the patient, such as a patient’s choice of providers and insurance plans. Any willing provider should have the ability to participate in health insurance plans. All patients should have access to emergency services, taking an active and leading role in their personal treatment decisions, the right to privacy and confidentiality, as well as considerate and respectful care from healthcare providers.
PCA has taken actions regarding this issue. Now it’s YOUR turn to make your position known:
US Senator: https://www.senate.gov/senators/senators-contact.htm
US Congressperson: https://www.house.gov/representatives/find-your-representative
Governor Tom Wolf: https://www.governor.pa.gov/contact/
PA Senator: https://www.legis.state.pa.us/cfdocs/legis/home/member_information/mbrList.cfm?body=S
PA Representative: https://www.legis.state.pa.us/cfdocs/legis/home/member_information/mbrList.cfm?body=H
New Provider Relief Funding Available
Today, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing $25.5 billion in new funding for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children’s Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
Get Ready to Apply! The application will open on September 29, 2021.
HHS/ CMS to mandate that Medicare & Medicaid facilities have COVID vaccine
HHS/CMS has not yet issued its final rule and it is unclear if chiropractors will be required to be vaccinated, but PCA will continue to disseminate information as it becomes available. The Interim Final Rule is to be published in October (with 30-day comment period).
Important Medicare Update
MASKING GUIDANCE INFORMATION
Residents in some Pennsylvania counties are being urged to wear masks again, regardless of vaccination status, this DOES NOT change the CDC recommendations for continued masking in Healthcare settings, including DC offices.
August 1, 2021
Residents in some Pennsylvania counties are being urged to wear masks again, regardless of vaccination status, due to transmission levels of COVID-19.
The U.S. Centers for Disease Control and Prevention updated its guidelines Tuesday to urge vaccinated people in certain areas of the country to resume wearing masks because of COVID-19.The CDC said people in areas with high or substantial COVID-19 transmission levels should resume wearing masks.
The PCA has consistently relied upon Federal and Pennsylvania mandates, guidance and recommendations for COVID-related matters. As of June 28, 2021, Pennsylvania will remove the masking requirements. The PCA sought clarification directly from the Pennsylvania Department of Health as to whether this lifting of the mask mandate applies to chiropractors and other health care providers.
Following is the response to PCA’s “mask guidance” question from Dr. Wendy E. Braund, COVID-19 Response Director for the PA DOH:
“Even though the statewide mask mandate will be lifted on June 28, DOH will continue to strongly recommend that healthcare providers follow CDC guidance, which includes the use of PPE by healthcare personnel in healthcare settings.”
Wendy E. Braund, MD, MPH, MSEd, FACPM
COVID-19 Response Director
Pennsylvania Department of Health
As of today, the CDC guidance for use of personal protective equipment (PPE), including masks, has remained unchanged. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-after-vaccination.html#anchor_1619116662704
To access the CDC recommendations, please click on this link: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
Get a POSTER for your office to promote HR2654 for Medicare
There is QR code to have patients click the link and then send a message to their Reps in seconds. WANT FULL MEDICARE ACCESS to exams x-rays therapies and to be able to help your Medicare fixed income patients to not have the out of pocket expenses or have to get their x-ray elsewhere? Well this is how you do it! Sample of 1 of 6 versions of the poster is shown, pick the one that "speaks" to you.
Courtesy of Dr. Dennis J. Fitterer, PCA Member and International Chiropractic Association Representative from Pennsylvania.
International Chiropractors Association Policy on Health Freedom Click Here To Read MoreRead More
Following is an informative and brief advisory (click on the article’s links, for Highmark’s observations and their plan) that demonstrates Highmark is targeting many more health professionals than DCs. HIGHMARK TARGETS HEALTH CARE FRAUD, WASTE, AND ABUSE (highmarkprc.com) – Sent to PCA courtesy of David J. Cutich, DC PCA Insurance CommitteeRead More
Interested in Getting Involved?
PCA 2021- 2022 PRIORITY LEGISLATION:
House Bill 171 of 2021: An Act limiting restrictive covenants in health care practitioner employment agreements.
House Bill 173 of 2021: An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, in special provisions relating to particular classes of insurers, providing for nondiscrimination by payers in health care benefit plans.
House Bill 225 of 2021: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in quality health care accountability and protection, further providing for definitions, for responsibilities of managed care plans, providing for preauthorization standards and for preauthorization costs, and providing for preauthorization and adverse determinations, for appeals, for uniform preauthorization form, for preauthorization exemptions.
House Bill 325 of 2021: Advisory Opinions from Licensing Boards
House Bill 916 of 2021: An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for nonopioid pain management care.
Delegation of Therapeutic Exercise to Unlicensed Personnel (no bill # yet)
Parity in Insurer Reimbursements (no bill # yet)
PID Direct Oversight and Enforcement Authority of Health Insurers’ Contracted Third Party Administrators (no bill # yet)
The staff at the home office has never been better. Our executive vice president is cordial, respectful, and a true leader who has years of experience which has helped the association greatly over the past number of years.
I'm thankful for the PCA and what we as an association have accomplished to protect the rights of chiropractors to practice as well as protecting the health of individuals throughout our state."
Ed Kropf, DC - Pittsburgh, PA
"As a PCA member over 31 years I have been a distant observer of Chiropractic in our state as well as the several factions of philosophy practiced here. As so far as the PCA is viewed, I feel the current system in place is providing the best communication with it's members. PCA has put into place several terrific members and administration that take on the problems from many fronts, report and attempt to correct/improve the position for the future of Chiropractic in our state.
Good job, you all are doing things so very much better, keep it up!!!"
The level of responsiveness from any direct inquires to the Execs or affiliates(legal, political) has always been unparalleled with Ed Nielson as Executive Director. Whether you are a member or not, you have benefited from battles won by the PCA that may have never crossed your front steps.
The PCA has been a major contributor to my success in practicing in Pennsylvania. I am grateful to serve and more grateful to have such selfless colleagues that freely donate hours and hours of their time for our benefit as Pennsylvania DCs!"
“I am a retired doctor, who was hit with a $17,000 recoupment request from a Pennsylvania health insurer, TWO years after I retired. As a retired-status member, I immediately contacted the Pennsylvania Chiropractic Association. PCA’s staff were responsive and very helpful, including referring me to Mr. Jason Martin, PCA’s General Counsel, for a free legal consultation.
After talking at some length with Mr. Martin, he assisted me with the audit and provided very solid advice. I followed his advice and I was able to resolve the audit with the health insurer without any payment on my part. I am thrilled with the supportI was given by PCA staff and General Counsel Martin’s legal advice.
Thanks to my membership in PCA, I received very responsive and immediate support for my problem. Most importantly, my membership in PCA saved me $17,000of my hard-earned money! Thank you, PCA!”
Lori Kalie, DC - Lancaster, PA
"I actually sold my practice. About two hours after you posted the ad, I got a call from a doctor who was interested. He officially took over today. I received quite a number of calls about the practice since the ad was up. The service you provide is valuable, and I just wanted to thank you and the PCA for offering this service."
Brian Meenan, DC - Pittsburgh, PA
"I just started my own practice a couple of months ago. $600 is a bit steep but it is worth it! Charge me monthly, that’d be great."
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