The chiropractic adjustment is a procedure in which trained specialists use their hands or a small instrument to apply a controlled, sudden force to a spinal joint. The goal of chiropractic adjustment, also known as spinal manipulation, is to correct structural alignment and improve your body’s physical function.
A chiropractic adjustment refers to a chiropractor applying manipulation to the vertebrae that have abnormal movement patterns or fail to function normally. The objective of this chiropractic treatment is to reduce the subluxation, with the goals of increasing range of motion, reducing nerve irritability, and improving function.
Chiropractic medical billing specialists must clearly understand the vocabulary related to chiropractic conditions. In order to get reimbursed by insurance for chiropractic services.
The patient must have a significant health problem which makes it necessary for the chiropractor to use musculoskeletal manipulation as a therapeutic remedy. The patient must have a spinal subluxation, as determined by the physical examination or x-ray.
The exact location of the subluxation must be clearly noted in the patient’s medical chart. These locations range from the occiput vertebrae in the neck to the sacral vertebrae and coccyx.
The patient must demonstrate at least two of the four symptoms of subluxation – pain/tenderness in a specific location, asymmetry/misalignment, and range of motion abnormality, and tissue or tone changes in soft tissue. One always has to be either asymmetry/misaligned or range of motion abnormality.
When it comes to payment, practitioners need to understand the nuances of chiropractic medical billing and coding which are quite different from that of other specialties. Medicare has special reimbursement rules, and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which came into effect on April 16, 2015, includes provisions related to chiropractic services.
Hiring Chiropractic Adjustments Medical Billing Services
Hiring a quality billing service is one of the most important decisions you’ll ever make regarding the business aspect of your practice. It is crucial that your billing company has the experience necessary to handle the complexities presented by Chiropractic medical billing and modifiers.
Benefits
- Improved collections and income
- Accelerated payments and reduced stress
- 24/7 accessibility to your patient data and financial information
- Real-time updates on revenue cycle
- Full financial and practice management reporting
- The peace of mind knowing billing is being handled by professionals & reimbursements and income will go up.
Medicare is a separate entity and has a completely different and separate fee schedule and billing policy. Medicare only covers adjustments when performed by a chiropractor. Though they can refer for X-rays, Medicare does not cover exams, therapies, or X-rays when performed by this specialist. Maintenance or non-active/non-acute adjustments are not covered.
If there are reasons to suspect that the claim may get denied by Medicare.
Many insurance plans only cover a certain number of chiropractic services per person per plan year. And so, it is important for your chiropractic medical billing company to have extensive experience in handling the complexities presented by chiropractic medical billing and modifiers.
FAQs
1. What is a chiropractic adjustment and how does it relate to billing?
A chiropractic adjustment is a procedure that uses controlled force to correct spinal alignment and improve function. For proper billing, it’s essential to document the location of the subluxation and symptoms clearly, as insurance requires these details for reimbursement.
2. What must be documented for a chiropractic adjustment to be covered by insurance?
The patient must have a spinal subluxation, confirmed by physical exams or X-rays. Additionally, the subluxation’s location and at least two symptoms (such as pain or range of motion abnormalities) must be documented for reimbursement.
3. How does Medicare handle chiropractic adjustments?
Medicare covers chiropractic adjustments only when performed by a chiropractor and has its own fee schedule and billing rules. It does not cover exams, therapies, or X-rays when performed by chiropractors, and maintenance adjustments are not reimbursed.
4. What are the benefits of hiring chiropractic medical billing services?
Outsourcing chiropractic billing improves collections, accelerates payments, and reduces stress. It also provides real-time financial updates and peace of mind knowing professionals are handling your reimbursements.
5. Why is chiropractic billing different from other specialties?
Chiropractic billing is more complex due to the unique terminology, modifiers, and specific requirements for subluxation documentation. Insurance policies, including Medicare, have special rules for chiropractic services, making specialized billing expertise essential.
