Transcription of Coding Guidelines Chiropractic Services
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Coding Guidelines Chiropractic Services
Coding Guidelines Chiropractic Services The diagnosis must be subluxation (see ICD-10-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: Use of X-rays: An x-ray may be used to document subluxation. The x-ray must have been taken at a time reasonably proximate to the initiation of a course of treatment. Unless more specific x-ray evidence is warranted, an x-ray is considered reasonably proximate if it was taken no more than 12 months prior to or 3 months following the initiation of a course of Chiropractic treatment. In certain cases of chronic subluxation ( , scoliosis), an older x-ray may be accepted provided the beneficiary's health record indicates the condition has existed longer than 12 months and there is a reasonable basis for concluding that the condition is permanent.
A previous CT scan and/or MRI is acceptable evidence if a subluxation of the spine is demonstrated. The x-ray must be made available to Medicare when requested. If the spinal x-ray(s) have been taken in a hospital or outpatient facility, a written report, including interpretation and diagnosis must be present in ... For CPT code 98940 ...
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