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Wiki documentation requirement for CPT 98941
- Thread starter pganley
- Start date
Your best option is always to follow Medicare Documentation Guidelines and the Local Coverage Determination (LCD) for your region unless the insurance company gives you specifics on what their preference is. Medicare wants specificity. This is taken from our LCD with Noridian as I am in South Dakota. Check with yours to verify the info is the same before going solely off of this:
Location of Subluxation:
The precise level of the subluxation must be specified by the chiropractor to substantiate a claim for manipulation of the spine.
This designation is made in relation to the part of the spine in which the subluxation is identified:
Area of Spine - Names of Vertebrae - Number of Vertebrae - Short Form or Other Name
Neck - Occiput (Occ, CO), Cervical (C1 thru C7), Atlas (C1), Axis (C2) - 7
Back - Dorsal (D1 thru D12) or Thoracic (T1 thru T12) or Costovertebral (R1 thru R12) or Costotransverse (R1 thru R12) - 12
Low Back - Lumbar (L1 thru L5) - 5
Pelvis - Iiii, r and l (I, Si)
Sacral - Sacrum, Coccyx, S, SC
In addition to the vertebrae and pelvic bones listed, the Ilii (R and L) are included with the sacrum as an area where a
condition may occur which would be appropriate for chiropractic manipulative treatment.
There are two ways in which the level of the subluxation may be specified.
- The exact bones may be listed, for example: C5, C6, etc.
- The area may suffice if it implies only certain bones such as: Occipito-atlantal (occiput and C1 (atlas)), lumbo-sacral (L5 and
Sacrum), sacro-iliac (sacrum and ilium).
Hope this helps
Location of Subluxation:
The precise level of the subluxation must be specified by the chiropractor to substantiate a claim for manipulation of the spine.
This designation is made in relation to the part of the spine in which the subluxation is identified:
Area of Spine - Names of Vertebrae - Number of Vertebrae - Short Form or Other Name
Neck - Occiput (Occ, CO), Cervical (C1 thru C7), Atlas (C1), Axis (C2) - 7
Back - Dorsal (D1 thru D12) or Thoracic (T1 thru T12) or Costovertebral (R1 thru R12) or Costotransverse (R1 thru R12) - 12
Low Back - Lumbar (L1 thru L5) - 5
Pelvis - Iiii, r and l (I, Si)
Sacral - Sacrum, Coccyx, S, SC
In addition to the vertebrae and pelvic bones listed, the Ilii (R and L) are included with the sacrum as an area where a
condition may occur which would be appropriate for chiropractic manipulative treatment.
There are two ways in which the level of the subluxation may be specified.
- The exact bones may be listed, for example: C5, C6, etc.
- The area may suffice if it implies only certain bones such as: Occipito-atlantal (occiput and C1 (atlas)), lumbo-sacral (L5 and
Sacrum), sacro-iliac (sacrum and ilium).
Hope this helps
ejlehman
Networker
With the coming of ICD-10, it is best to encourage the doctor to be specific and document where he is adjusting (region, vertebra, and direction). I have had a few audits that this has been questioned. Many payers are asking for notes more and more and it is best too have too much than too little.