Chiropractors coding updates in 2021

It has been witnessed that the demand for chiropractic care is increasing owing to a combined treatment for numerous musculoskeletal conditions. Chiropractors practice different techniques in order to lower pain, boost function, and improve mobility in the body. Nevertheless, there are particular codes and billing guidelines to identify such kinds of services.

With the help of chiropractic services, chiropractic medical billing specialists advised sending the correct message to insurance companies, increase revenue, and prevent audits. It is a need of an hour to have knowledge of the latest guidelines about chiropractic coding, billing, and compliance. Without wasting time let’s jump on to what are the specific changes in chiropractors coding and its updates in 2021.

Changes to the Chiropractic CPT Code in 2021:

Two new codes for dry needling

In 2021, two additional CPT codes were approved by the AMA (American Medical Association) CPT Editorial Panel to track dry needling of musculature trigger points.

Newly added codes are as follows:

  • 205X1, needle insertion without injection, 1 or 2 muscles.
  • 205X2, needle insertion without injection, 3 or more muscles

The AMA has also introduced new recommendations for code 97140 Manual therapy methods such as physical lymphatic drainage, mobilization/manipulation, manual pressure, 1 area or more) and acupuncture codes (97810-97814) to use the newly introduced codes for dry trigger point acupuncture and dry needling.

Replacement of online evaluation codes

Codes such as 98969 for non-physician and 9944 for physicians for online evaluation have been replaced in 2021. New guidelines associated with these codes include exclusion about where these codes can be used and where it is prohibited.

Health and Behavior Intervention/ Assessment

There has been a replacement and addition of codes 96150 to 96152 with nine codes and changes in the chiropractors coding guidelines. The new codes split the services into groups, family, and individual, also include descriptions of intervention and assessment along with time-based reporting with additional codes.

New Category III codes for Health and Well-being Coaching

These codes have been launched for specially-trained non-physicians in order to take care of the patient for good health.

  • 0593T group (two or more individuals), at least 30 minutes
  • 0592T individual, follow-up session, at least 30 minutes
  • 0591T Health and Well-Being Coaching face-to-face; individual, initial assessment

These services cannot be reported with the Health and Behavior Assessment/Intervention codes.

Replacement of code 90911 with two new codes

There are presently two pure codes of biofeedback, which are 90901 and 90911. Code 90901 Biofeedback training according to any method of treatment will remain untouched. Code 90911 Pelvic floor preparation for incontinence care has been omitted and altered with two new codes that also have modifications to the official guidelines for publishing.

Elimination of muscle testing procedure codes

The CPT codes 95831-95834, which recognize manual muscle testing processes have been eliminated. CPT guidelines recommend using 97161-97172 Evaluation and re-evaluation of a patient by an athletic trainer, physical therapist, and occupational therapist instead. Range Motion codes remain unchanged.

Chiropractors coding guidelines regarding ICD-10 codes

In 2021, there will be no modification in the ICD-10 codes, which have been used by chiropractors occasionally. Nevertheless, one significant change is made in Section 19.c of the Official ICD-10-CM Coding Guidelines for the growth plate fractures, which is as follows.

For physeal fractures, allocate only the code recognizing the type of physeal fracture. Don’t allocate a special code to find out the specific bone, which is fractured.

The above mentioned are the chiropractor guidelines in 2021, hope you will be able to understand the protocols and rules in order to take care of your patients.