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Chiropractic Billing Made Simple

Chiropractic care faces unique billing challenges with strict documentation requirements, frequent audits, and payer-specific rules for:
✔ Spinal manipulative treatments (SMTs)
✔ Corrective exercise therapies
✔ Physiotherapy modalities
✔ Maintenance care vs. active treatment

We help DCs and chiropractic clinics:
✅ Increase reimbursements by 20-40%
✅ Reduce denials with compliant coding
✅ Avoid audits through proper documentation
✅ Navigate Medicare/Medicaid requirements

We Specialize in Chiropractic-Specific Billing

✅ Spinal Manipulation (98940-98943)

  • Region-specific coding (cervical, thoracic, lumbar, pelvic)

  • Documenting medical necessity for each segment

  • Modifier AT requirements for Medicare

✅ Therapeutic Procedures (97110-97140)

  • Corrective exercises (97110)

  • Manual therapy (97140)

  • Neuromuscular re-education (97112)

✅ Modality Billing

  • Electrical stimulation (97032)

  • Ultrasound (97035)

  • Traction (97012)

✅ Maintenance Care Billing

  • Documenting functional goals

  • Payer-specific rules (some don’t cover maintenance)

  • Wellness vs. medical billing strategies

Top Chiropractic Billing Challenges We Solve

1. Medicare Compliance (Modifier AT & ABNs)

🚩 Problem: Claims denied for missing modifier AT (Active Treatment)
💡 Our Fix:

  • Ensure proper ICD-10 codes (e.g., M99.01 for segmental dysfunction)

  • Document subluxation findings (x-ray, palpation, ROM)

  • File ABNs when maintenance care isn’t covered

2. Denials for “Lack of Medical Necessity”

🚩 Problem: Insurers reject claims for insufficient documentation
💡 Our Fix: We ensure your notes include:
✔ SOAP format with objective findings
✔ Functional improvement goals
✔ Progress assessments

3. Therapy Bundling Issues

🚩 Problem: Modalities (97032) denied when billed with adjustments
💡 Our Fix:

  • Proper use of modifier 59 for distinct services

  • Time-based documentation for 97110

  • Separate notes for each therapy

4. Workers’ Comp & Auto Injury Billing

🚩 Problem: Delayed payments from PI attorneys or WC carriers
💡 Our Fix:

  • Pre-authorization tracking

  • LOP management for auto injury cases

  • Medicare Set-Aside (MSA) compliance

Why Choose Our Chiropractic Billing Service?

🔹 Chiropractic-Only Expertise – No guesswork on coding rules
🔹 Higher Reimbursements – We catch missed billing opportunities
🔹 Fewer Denials – 96% clean claim rate
🔹 Audit Protection – Bulletproof documentation
🔹 Transparent Reporting – Monthly performance analytics

Technology Features:

  • Automated eligibility checks

  • Real-time claim tracking

  • Custom denial alerts