Recent News
NYS WCB OnBoard Limited Release Update
Recap: This first phase, OnBoard Limited Release, will allow providers to easily submit Prior Authorization Requests (PAR) for care, as well as a Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0). Once implemented, carriers must respond to...
GHI EmblemHealth Reimbursement Issues
Several NYSCA members have again reached out to The NIC to inform us that they are not being reimbursed by GHI / Emblem. Unfortunately The NIC had to again request assistance from the NYS Department of Financial Services, with whom we have developed an excellent...
Recent BCBS Notices
As some of you are aware, Empire BCBS sent a 'collaborative and educational' notice to those providers who billed CPT code 97110 (therapeutic exercise, direct one-on-one patient care, 15 minutes) 'outside of the average utilization'. Empire BCBS asked...
ICD Coding Reminder
M54.50, Low back pain, unspecified M54.51: Vertebrogenic low back pain M54.59: Other low back pain As previously reported, CMS has deleted ICD Code M54.5 Low Back Pain effective October 1, 2021 and replaced with the following three ICD10 Codes to offer additional...
Advertising a Pain Relief Center without mentioning a chiropractic connection
A member recently called and asked if it is illegal for a chiropractor to do an advertisement for a pain relief center and not mention they are a chiropractor or include D.C. [in the advertisement]. Q1: May a chiropractor advertise a pain relief center and not mention...
Softwave Regenerative Technologies and Therapy
A member relates and asks: About 3 months ago I started seeing ads for a new technology – the Softwave Regenerative Technology. It caught my eye because it is shown to restore and heal damaged tissue by stimulating increased production and an aggregation of stem cells...
Providing DME Under New York State Workers’ Compensation
(Statement from Elite Medical Supply of NY) Elite Medical Supply of New York has requested that the NYSCA provide the following statement to our members: In early February 2020, the New York State Chiropractic Association graciously forwarded my statement to its...
Providing DME Under New York State Workers’ Compensation (Update)
Last year (2020), the New York State Chiropractic Association (NYSCA) learned that the NYS Workers Compensation Board (NYS WCB) had initiated inquiries with a few providers authorized to treat injured workers who had signed private agreements with one or more durable...
Charging an independent contractor a percentage of monies collected
Q: May a field doctor hire or retain an independent contractor in her office and have the independent contractor pay the host doctor/facility a percentage of the monies the independent contractor collects from the payment for her services? Paraphrasing, a member...
New Years (Insurance) Resolutions
Greetings fellow doctors and welcome to 2021. The NYSCA Insurance Committee (the NIC) offers the following report to keep our members up to date on recent insurance issues which may impact your practice: Aetna Issue: NYSCA Members have expressed their frustration...
CPT Code Changes Effective January 1, 2021
This year brings approximately 300 changes in CPT codes impacting nearly every profession. The vast majority of these changes do not impact doctors of chiropractic; however, there is one relative to our evaluation and treatment of our patients. After many years of...
Substitute Providers and NPI Numbers
Background: A member, a sole proprietor who is partially disabled as a result of an accident and who is an in-network with most health plans in her area, wants to engage another DC (who covers other chiropractic practices) as an independent contractor and use the...
Office Rental Space and the Americans with Disabilities Act
Background: Paraphrasing generally, a field doctor states, then asks: I have to move my office. I have located office space on the second floor in a small building. The building has large hallways and doorways and, in that sense, is compliant with the...
Can a network administrator deny reimbursement for chiropractic care provided under state Workers’ Compensation Law?
Q: Can chiropractic care be denied reimbursement under New York State Compensation Law for treatment tendered to an injured worker following the state workers’ compensation medical treatment guidelines simply because the DC provider is out-of-network. A member states:...
New Workers’ Compensation DME Rules and Fee Schedule
NYSCA has previously communicated that the revised January 1, 2020 New York Workers' Compensation Fee Schedule included reference to an updated Durable Medical Equipment (DME) Fee Schedule. Just last month the Workers' Compensation Board (WCB) released another...