Chiropractic Superbill Template PDF Details

In the realm of chiropractic care, documentation and billing processes are integral to practice management, not only to ensure the provision of efficient patient care but also to maintain the financial health of the practice. Among the myriad of forms and paperwork, the Chiropractic Superbill stands out as a comprehensive and crucial document that encapsulates a wide array of information critical for both the practitioner and the patient. This form meticulously records various aspects of a patient's visit, including personal information, the date of service, detailed descriptions of the services provided along with their respective fees, and, importantly, the codes associated with each service. Covering everything from office visits distinguished by patient status — either new or established — to a broad spectrum of modalities, ranging from passive treatments like hot or cold packs and electric stimulation to active ones that include therapeutic exercises and neuromuscular re-education, the superbill serves multiple purposes. It not only facilitates the accurate billing of services rendered but also acts as a clear communication tool between the healthcare provider and insurance companies. Furthermore, the form lists chiropractic manipulative treatment procedures, various X-ray examinations, and an assortment of miscellaneous items, such as ice packs, cervical pillows, and lumbar supports, detailing each with specific codes and fees. This all-encompassing document is essential for streamlining coding and billing workflows, thereby playing a pivotal role in the optimization of practice operations and the enhancement of patient satisfaction through transparent billing practices.

QuestionAnswer
Form NameChiropractic Superbill Template
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameschiropractic superbill online, chiropractic superbill forms, chiropractic template form, chiropractor invoice

Form Preview Example

PATIENT NAME:_____________________________________ DATE OF SERVICE: ____________________

CODE

DESCRIPTION

FEE

CODE

DESCRIPTION

FEE

OFFICE VISITS - NEW PATIENT

 

PASSIVE MODALITIES

 

99201

BRIEF

 

97124

Massage

 

99202

LIMITED

 

97035

Ultrasound

 

99203

INTERMEDIATE

 

97014

Electric Stim

 

99204

EXTENDED

 

97016

Vasopneumatic

 

99205

COMPREHENSIVE

 

97033

Iontophoresis

 

CNPO NEW PATIENT

 

97010

Hot/Cold Pack

 

 

 

 

97024

Diathermy

 

OFFICE VISITS - ESTABLISHED PATIENT

 

64660

Neurostimulator

 

99211

MINIMAL

 

97012

Mechanical Traction/ Intersegmental

 

99212

BRIEF

 

97140

Manual Therapy Units ________

 

99213

LIMITED

 

 

 

 

99214

INTERMEDIATE

 

ACTIVE MODALITIES

 

99215

EXTENDED, COMPREHENSIVE

 

97112

Neuromuscular Re-education

 

CEPO EXISTING PATIENT

 

97110

Therapeutic Exercise

 

 

 

 

97530

Kinetic Activity

 

 

 

 

97535

ADL Home

 

CMT PROCEDURES

 

97537

ADL Work

 

98940

CMT 1-2 REGIONS

 

97116

Gait Training

 

98941

CMT 3-4 REGIONS

 

 

 

 

98942

CMT 5 REGIONS

 

 

 

 

98943

CMT - EXTREMITIES

 

XRAY

 

 

CADJ ADJUSTMENT

 

72020

Single View, Cervical

 

 

 

 

72040

Cervial 2 views

 

 

 

 

72050

Cervial, 4 views

 

MISCELLANEOUS

 

72052

Cervical 7 views

 

E0230

Ice Pack

 

72070

Thoracic, 2 views

 

99070

Biofreeze

 

72100

Lumbar, 2 views

 

99070

Electric Stim Pads

 

72110

Lumbar, 4 views

 

99070

Vitamins

 

73020

Shoulder, 1 view

 

E0643

Cervial Pillow

 

73030

Shoulder, 2 views

 

L0500

Lumbar Support

 

73060

Humerus, 2 views

 

A4556

Stim leads

 

73070

Elbow, 2 views

 

E0730

TENS Unit Rental

 

73080

Elbow, 3 views

 

E0730

TENS Unit Purchase

 

73090

Forearm, 2 views

 

L2020

Orthotics

 

73110

Wrist, 3 views

 

 

 

 

73120

Hand, 2 views

 

 

 

 

73130

Hand, 3 views

 

 

 

 

73550

Femur, 2 views

 

 

 

 

73560

Knee, 2 views

 

 

 

 

73562

Knee, 3 views

 

 

 

 

73590

Tib/Fib, 2 views

 

 

 

 

73610

Ankle, 3 views

 

 

 

 

73620

Foot, 2 views

 

 

 

 

73630

Foot, 3 views

 

 

 

 

73650

Calcaneous, 2 views

 

How to Edit Chiropractic Superbill Template Online for Free

It is a breeze to fill out the superbills for chiropractors. Our PDF tool was designed to be easy-to-use and let you fill in any form fast. These are the four actions to take:

Step 1: The very first step will be to click the orange "Get Form Now" button.

Step 2: Now, you can begin editing your superbills for chiropractors. The multifunctional toolbar is readily available - insert, eliminate, adjust, highlight, and undertake other sorts of commands with the text in the form.

The PDF document you decide to fill out will consist of the next areas:

part 1 to writing chiropractor invoice

Step 3: As soon as you are done, hit the "Done" button to upload the PDF document.

Step 4: To avoid any sort of concerns in the foreseeable future, be sure to create minimally a few copies of your form.

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