Explanation of Services/Procedure Codes We at Osage County Chiropractic, P.A. are required to use these procedure codes for the services that are provided. In the past we have had some situations when patients do not understand why we have billed certain codes. We have chosen to provide you with this information to bring more clarification to why and how we will be billing the services you will be receiving. If you have any questions please ask prior to seeing Dr. Kuder New Patient - One who has not received any professional services from the physician within the past three years. Procedure codes-99201, 99202, 99203. These codes are used for evaluation and management services for a new patient. These codes WILL be used for patients who have not been here within the past three years. Established Patient -One who has received professional services from the physician within the past three years. Procedure codes- 99212, 99213. These codes are used for evaluation and management services for an established patient. These codes WILL be used if a patient has not been here within the past year and CAN be used when a patient presents with a different physical complaint since their last visit or has not been here in the past few months. Chiropractic Adjustment- A manipulation of the spine or other articulations of the body to normalize function. Procedure codes-98940, 98941, 98942. *Soft tissue muscle techniques/Extra Spinal - Dr. Kuder uses his hands to assess muscle groups/joints for tension, lack of movement or decreased range of motion. These techniques combine active movements by the patient with directed manual pressure or tension on the muscle or affected areas and joints. Procedure codes-97140,98943 *This definition is a combination of multiple procedure codes. ****Dr. Kuder’s specialty is combining the chiropractic adjustment with the muscle techniques. These are TWO separate services and WILL be billed according to the specific procedure(s) and the level at which it is performed.***** I have read, asked questions if needed and understand the above information. Signature__________________________________Date____________________________ 9/1/10