Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.

Appellate Terms of the Supreme Court of New York

Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.

CourtAppellate Terms of the Supreme Court of New York

DecidedApril 27, 2017

Docket2017 NYSlipOp 50598(U)

StatusPublished

This text of Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co. (Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.) is published on Counsel Stack Legal Research, covering Appellate Terms of the Supreme Court of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co., (N.Y. Ct. App. 2017).

Pincite

Opinion

Spineisland For Chiropractic, P.C., as Assignee of Naudia Tiwari, Appellant,

against

21st Century Advantage Insurance Company, Respondent.

Law Office of Gabriel & Shapiro, LLC (Steven F. Palumbo, Esq.), for appellant. Law Office of Bryan M. Rothenberg (Deepak D. Sohi, Esq.), for respondent.

Appeal from an order of the District Court of Suffolk County, Third District (C. Stephen Hackeling, J.), dated December 23, 2015. The order, insofar as appealed from as limited by the brief, granted the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under CPT code 95831.

ORDERED that the order, insofar as appealed from, is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint, arguing that it had paid plaintiff for the services at issue in accordance with the workers' compensation fee schedule. In an order dated December 23, 2015, the District Court granted defendant's motion in its entirety. On appeal, plaintiff argues that the District Court should have denied the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under CPT code 95831.

Contrary to plaintiff's argument, defendant sufficiently demonstrated, prima facie, that it had properly applied CPT code 95833 to the services that had been billed by plaintiff under CPT code 95831, and plaintiff failed to raise a triable issue of fact with respect thereto (see Sama Physical Therapy, P.C. v American Tr. Ins. Co., 53 Misc 3d 129[A], 2016 NY Slip Op 51359[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]).

Accordingly the order, insofar as appealed from, is affirmed.

Marano, P.J., Garguilo and Brands, JJ., concur.

Decision Date: April 27, 2017

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Spineisland For Chiropractic, P.C., as Assignee of Naudia Tiwari, Appellant,

against

21st Century Advantage Insurance Company, Respondent.

Law Office of Gabriel & Shapiro, LLC (Steven F. Palumbo, Esq.), for appellant. Law Office of Bryan M. Rothenberg (Deepak D. Sohi, Esq.), for respondent.

Appeal from an order of the District Court of Suffolk County, Third District (C. Stephen Hackeling, J.), dated December 23, 2015. The order, insofar as appealed from as limited by the brief, granted the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under CPT code 95831.

ORDERED that the order, insofar as appealed from, is affirmed, without costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint, arguing that it had paid plaintiff for the services at issue in accordance with the workers' compensation fee schedule. In an order dated December 23, 2015, the District Court granted defendant's motion in its entirety. On appeal, plaintiff argues that the District Court should have denied the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under CPT code 95831.

Contrary to plaintiff's argument, defendant sufficiently demonstrated, prima facie, that it had properly applied CPT code 95833 to the services that had been billed by plaintiff under CPT code 95831, and plaintiff failed to raise a triable issue of fact with respect thereto (see Sama Physical Therapy, P.C. v American Tr. Ins. Co., 53 Misc 3d 129[A], 2016 NY Slip Op 51359[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]).

Accordingly the order, insofar as appealed from, is affirmed.

Marano, P.J., Garguilo and Brands, JJ., concur.

Decision Date: April 27, 2017

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Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co., Counsel Stack Legal Research, https://law.counselstack.com/opinion/spineisland-for-chiropractic-pc-v-21st-century-advantage-ins-co-nyappterm-2017.