While I appreciate your note, the insurance company disagrees with you. Before posting my note, I called them, and went up the ladder to verify it.

The insurance company has a list of procedure codes, and a separate list of diagnosis codes. In order to get paid, the procedure code and a diagnosis code must 'match.' you couldn't get paid on a procedure code of 'massage therapy' with a diagnosis code of 'tooth pain.' The fact that the procedures MATCH the diagnoses - massage therapist & back pain, colonic therapy & IBS, speech therapy & lisp, etc., is the key here. Obviously if the colonic therapist wrote down 'colon surgery' and 'IBS' they'd be in big trouble. But 'colon therapy' and 'IBS' are an appropriate match, nobody gets in trouble, and you get paid. This is what the insurance company has said.

You mention that colon hydrotherapists have been shut down for lesser 'offenses' than this. Just curious to know what offenses they have been shut down for. Can you fill me in?

Thanks,
Lisa