Chiropractic Manipulative Treatment Denials

• OA-18 - Duplicate Service(s): Same service submitted for the same patient, same date of service by same doctor will be denied as a duplicate
• CO-151 - Information provided does not support this many/frequency of services. Same service submitted for the same patient, same date of service by the same provider will be denied. 
• CPT codes: 98940, 98941, 98942 

Resolution/Resources
First: Verify the status of your claim before resubmitting. You can determine the status of a claim through the Palmetto GBA eServices tool or by calling the Palmetto GBA Interactive Voice Response (IVR) unit. 

Online Claim Status Verification through eServices

• All providers that have an EDI Enrollment Agreement on file may register to use this tool. If you haven’t already registered, please consider doing so.  
• Please note: Only one provider administrator per EDI Enrollment Agreement/per PTAN/NPI combination performs the registration process. The provider administrator can then grant permission to additional users related to that PTAN/NPI.
• Billing services and clearinghouses should contact their provider clients to gain access to the system
• Specific instructions for accessing claim status information through eServices are available in the eServices Users Manual (PDF, 8.33 MB)

Please note:

• Only one chiropractic manipulative treatment will be allowed per day