Billing and Coding: Chiropractic Services

Medicare covers only manual spinal manipulation (CPT 98940–98942) performed by chiropractors for treatment of documented spinal subluxation, with the precise subluxation level reported as the primary diagnosis and the neuromusculoskeletal condition as secondary. Claims must include diagnosis codes and required claim data, use the AT modifier for active/corrective treatment, and exclude non-manual and extraspinal services (CPT 98943); maintenance therapy after maximum therapeutic benefit is not covered.

"Medicare covers manual manipulation of the spine (chiropractic manipulative treatment) for treatment of spinal subluxation using CPT codes 98940, 98941, or 98942 when medically necessary."

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