Chiropractic manipulation, also known as spinal mobilization or manual therapy, is a procedure where chiropractors use their hands or a small instrument to apply a sudden force to a spinal joint. The goal is to improve spinal motion and physical function, and can also help reduce inflammation, improve nerve function, and relieve pressure on joints.
Chiropractors often focus on five spinal regions during manipulation:
Chiropractic Spinal Regions
| Region | Description |
|---|---|
| Cervical region | The joint that connects the neck to the head, also known as the atlanto-occipital joint |
| Thoracic region | The mid-back, which includes the costovertebral and costotransverse joints |
| Lumbar region | The lower back, which includes the L1 through L5 vertebrae |
| Sacral region | The sacrum, which includes the sacrococcygeal junction |
| Pelvic region | The sacro-iliac joint and other pelvic articulations |
Chiropractors use Current Procedural Terminology (CPT) codes to bill for services. Under Medicare, chiropractors can use three CPT codes for chiropractic services: 98940, 98941, and 98942. These codes are used for chiropractic manipulative treatment of the spine, with 98940 for one to two regions, 98941 for three to four regions, and 98942 for five regions.
Chiropractic Cpt Codes
| Code | Description |
|---|---|
| 98940 | CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 1-2 REGIONS |
| 98941 | CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS |
| 98942 | CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS |
| 98943 | CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); EXTRASPINAL, 1 OR MORE REGIONS |
Chiropractic Subluxation Diagnosis Codes
| Code | Description |
|---|---|
| M99.00 | Segmental and somatic dysfunction of head region |
| M99.01 | Segmental and somatic dysfunction of cervical region |
| M99.02 | Segmental and somatic dysfunction of thoracic region |
| M99.03 | Segmental and somatic dysfunction of lumbar region |
| M99.04 | Segmental and somatic dysfunction of sacral region |
| M99.05 | Segmental and somatic dysfunction of pelvic region |
When billing for these codes, chiropractors must use the Acute Treatment (AT) modifier to indicate active or corrective treatment of an acute or chronic subluxation. The AT modifier should not be used for maintenance therapy. Chiropractors must also consider the following when billing:
- Report the initial treatment procedure
- Report the date of any X-rays, including the film
- If an X-ray is not available, use a physician’s examination to document subluxation
- Use the recommended ICD-10-CM code to report subluxation
- Categorize treatment procedures as maintenance therapy, chronic subluxation, or acute subluxation
Chiropractors may also use other CPT codes for additional services, such as:
-
- 97016: Using vasopneumatic devices to increase circulation
- 97022: Using warm paraffin wax baths to relieve pain and speed healing
- 97028: Using ultraviolet light therapy for therapeutic reasons
- 97150: Group therapeutic procedures that focus on the extremities
- 97750: Testing a person’s physical capabilities and limitations
- 97110: Using exercise to develop strength, endurance, range of motion, and flexibility