HEDIS® Requirements for the Use of X-rays with Low Back Pain

Many insurance carriers have recently introduced HEDIS^® measures policies on when an x-ray should be taken if a patient presents with low back pain.  Every provider should be aware of the insurance carrier’s policy on radiographs with spine pain.  Knowledge of the measure will influence your medical decision-making and your required documentation when applicable.  Dr. Mario Fucinari will define what circumstances will trigger the medical necessity for x-rays, the needed documentation, and appropriate ICD-10 codes.  Learn from a certified compliance officer and seasoned practitioner of 35 years how to incorporate these latest developments into your practice.  Perfect for doctors, staff, and students.

Learning Objectives

• Attendees will learn how to justify their care through documentation and coding
• Realize the consequences of denials and recoupments in the chiropractic office
• Learn what conditions represent red flags, necessitating further tests
• Apply knowledge to design a treatment plan that shows the rationale for care
• Be able to describe elements of the patient’s history to avoid denials
• Learn the common errors in documentation and coding that lead to denials 

This course was  orginally presented by Dr. Mario Fucinari on November 16, 2022, and sponsored by the Illinois Chiropractic Society.