Engineered Revenue Cycle & Documentation Integrity for Chiropractic Practices.

Medicare Local Coverage Determinations (such as LCD L34585) require spinal subluxation to be demonstrated by either X-ray or physical examination meeting the P.A.R.T. criteria (Pain, Asymmetry, Range of motion abnormality, Tissue tone changes). At least two of the four criteria must be documented, and one must be Asymmetry or Range of Motion. JORVUS EHR and billing validation scrubbers prevent claims from generating unless these specific clinical elements are confirmed in the patient chart, eliminating post-payment recoupments.

Under National Correct Coding Initiative (NCCI) edits, CPT 97140 is considered bundled into CMT codes if performed in the same anatomic region. To bill both, manual therapy must be performed in a separate, distinct anatomical region and documented with separate time logs and rationale. JORVUS automatically audits the documentation for distinct regional mapping and time thresholds before appending modifier 59 or XE/XS, ensuring compliant claims that pass automated clearinghouse filters.

Personal injury accounts are segregated into dedicated sub-ledgers. Our team coordinates directly with auto insurance adjusters to track PIP/MedPay policy limits. Once PIP is exhausted, the software automatically transitions the balance to the attorney lien/Letter of Protection (LOP) ledger, preventing balance write-offs and equipping your clinic with audited itemized billing ledgers when settlement talks begin.

Medicare only covers active, medically necessary spinal manipulation aimed at objective functional recovery. When a patient reaches maximum medical improvement and enters palliative or maintenance care, the -AT modifier can no longer be used. JORVUS prompts the clinical team when treatment plans reach recovery plateaus, triggering the execution of an Advance Beneficiary Notice of Noncoverage (Form CMS-R-131) and automatically appending modifier -GA for compliant non-covered claims.