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This article provides billing and coding guidelines for Chiropractic services. Coverage of Chiropractic services is a limited benefit. The coverage is limited to manual manipulation for the treatment of subluxation.
For CPT code 98940, Chiropractic manipulative treatment (CMT), one or two regions, the claim form can accept the four diagnoses that may be appropriate. For CPT codes 98941 and 98942, the chiropractic physician should enter into Item 21 on the CMS1500 claim form or the electronic equivalent, the two
Chiropractic Services The diagnosis must be subluxation (see ICD-9-CM Codes that Support Medical Necessity Section in this policy). Subluxation is defined as the incomplete dislocation, off centering, misalignment, fixation or abnormal spacing of vertebrae or intervertebral units. Subluxations are classified as either:
Medicare allows only services that are medically necessary, except as mandated by statute. For chiropractic services, this means the patient must have “a significant health problem in the form of a neuromusculoskeletal condition necessitating treatment, and the manipulative services rendered must have a direct, therapeutic relationship to the
Choosing specific chiropractic Medicare diagnosis codes ensures you are correctly reporting. Read from ChiroTouch how to use the right codes for your notes.
This Billing and Coding Article provides billing and coding guidance for Chiropractic Services. Coding Guidance Notice: It is not appropriate to bill Medicare for services that are not covered as if they are covered. When billing for non-covered services, use the appropriate modifier. When billing for Chiropractic services:
The diagnosis code(s) must best describe the patient's condition for which the service was performed. For diagnostic tests, report the result of the test if known; otherwise the symptoms prompting the performance of the test should be reported.
Do you need coverage for chiropractic services due to back pain, stiff, aching neck? Find out what Medicare costs are for chiropractic treatment.
Provide a sampling of chiropractic billing concepts and guidelines to give you a better understanding of the Medicare Program, while helping to decrease your National Government Services claim submission billing errors. 4
All claims for chiropractic services must include the following information: Date of the initiation of the course of treatment. Symptom/condition/Secondary diagnosis code(s)