As the industry continues to focus on value-based care, it is becoming more important than ever to reduce costs and increase efficiency. Careeo’s team of chiropractic billing experts can help you reach the forefront of new emerging payment models while gaining better data that allows you to provide a higher quality of care.
Chiropractic billing can be extremely complex, and that can sometimes lead to unnecessary strain on the finances of chiropractic practices. In fact, it is estimated that 83 percent of claims fail to meet at least one documentation requirements, leading to Medicare inappropriately paying about $178 million per year. All of this complexity means that coding and billing take up an enormous amount of time and resources to the average practice, and there are still countless errors, leading to denials and underpayments
Chiropractic CPT codes are some of the most important components of the insurance billing process. Accurate chiropractic insurance billing is essential for your practice’s revenue cycle management, but errors can cause costly denials and delays.
Chiropractic billing requires almost the same level of professional skills and knowledge as chiropractic medicine itself. You need skilled coders and billers who know how to apply the correct modifiers, such as AT, to ensure that all of your claims are appropriately submitted.
Four Essential Chiropractic CPT Codes
While there are numerous chiropractic CPT codes, there are four main CPT codes chiropractors use. Each code represents a specific region of the spine that was treated. These main codes are as follows:
98940 Chiropractic Manipulative Treatment (CMT)
Used for the examination, diagnosis, and manipulative treatment of one to two spinal regions.
98941 Chiropractic Manipulative Treatment (CMT)
Used for the examination, diagnosis, and manipulative treatment involving between three and four spinal regions.
98942 Chiropractic Manipulative Treatment (CMT)
Used for the examination, diagnosis, and manipulative treatment involving five or more spinal regions.
98943 Chiropractic Manipulative Treatment (CMT)
Used to report chiropractic manipulation of one or more of the extra-spinal regions.
Three Essential Chiropractic Modifiers
Modifier AT
Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942)
Modifier 25
This Modifier is used to report a significant and separately identifiable Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician or other qualified healthcare professional.
Modifier 59
Use this Modifier to report a procedure or service that was distinct or independent from other non-E/M services performed on the same day.
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