The North American Spine Society (NASS) has issued a "special alert" to all of its members regarding a "cracking down on health fraud" by the Health Care Financing Administration (HCFA) and the U.S. Department of Justice. The alert includes these sobering facts:
• "The OIG (Office of the Inspector General) plans to double its staff by 2002 to investigate health fraud.
• "For every dollar that the OIG spends to track down fraud, it recovers $10.
• "There are expanded civil and criminal penalties for health fraud, including fines of $10,000 PER OFFENSE (emphasis theirs), mandatory 1-3 year jail sentence for a felony fraud conviction, and exclusion from participation in federal programs."
The Health Insurance Portability and Accountability Act of 1996 (aka the Kennedy-Kassebaum bill, HR 3103) has provided $820 million over seven years to the Office of the Inspector General for health fraud investigation. Those funds have been allotted to the FBI ($548 million) and the Department of Justice ($330 million).
The primary suggestion made by NASS is for providers to learn and use "correct coding" when billing for reimbursement. This not only helps ensure payment, but can also protect a provider from future accusations.
About the NASS: The NASS, begun 14 years ago, defines itself as a "multidisciplinary organization that advances quality spine care through education, research and advocacy." NASS currently has 2,038 members (1,934 from the U.S.). Sixty-three percent of NASS members are orthopaedic surgeons; 18 percent are neurosurgeons; and 9% are physiatrists.
NASS has six categories of membership. Chiropractors are in the "affiliate" membership group, which also includes PTs, PAs, nurse practitioners and other allied health care professionals and individuals involved in spine research/development. The affiliate group accounts for only two percent of NASS membership.
The NASS meets annually. This year's meeting (Chicago, October 20-23) will feature guest speakers Dr. C. Everett Koop, former Surgeon General of the United States, and Dr. John Eisenberg, the AHCPR's administrator, among others.
The NASS website is www.spine.org .
Recent laws in New Jersey and California represent a disturbing trend that will negatively impact a practice’s ability to collect monies from patients, as well as expose them to significant penalties if the practice does not follow the mandatory guidelines to a T. Please be aware that a similar law may be coming to your state. The time to act is before the law is passed.
With estimates showing over 30 million Americans affected by peripheral neuropathy – and a significant portion underdiagnosed – it’s increasingly likely that chiropractors are already treating these patients. What’s missing is structured recognition, comprehensive management and targeted tools to slow progression, improve function and support systemic health.
Each year, ICD-10-CM is updated on Oct. 1. For 2026, there are 74,179 total codes, with 487 additions, 28 deletions and 38 revisions. Code changes are based on date of service, not the claim submission date. Services performed on/after Oct. 1 must use the new codes. While no changes affect the common spinal or extraspinal codes most frequently used by DCs, several updates may still affect your claims – particularly for comorbidities, referred pain, or trauma cases.
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