Ensuring Proper Review

To ensure a proper review, submit the following documentation:

• Medicare Remittance Notice
• Carrier Request For Review form
• Physician’s medical records for date of service at issue
• Initial visit records for current illness or injury
• X-ray report for acute condition or demonstration of subluxation by X-ray

Note that down coding, or billing with a single code regardless of the patient’s condition, is wrong even if it gets your claims paid. Bill for and document the services you render at the level you provide them. Down coding can cause you to look different and may subject you to other reviews.