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Good Morning
11:56:07 AM CDT
Wednesday, April 23, 2014

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Chiropractic Services

Topics Palliative Care Requirements Forms & Publications Provider Request for Adjustment (M6) form
General Information Documentation Requirements First Report of Injury (FROI) Form Chiropractic Progress/Final Report (C25)
Chiropractic Treatment Window Subsequent Treatment Capability Assessment form (C3) Utilization Review Chiropractic Request (UR-Chiro)
Authorization Process   Medical Services Dispute Resolution Request (M2) Quick Tips for Chiropractors

Documentation requirements

Documentation should provide detailed information on treatment being provided and is required to be typed. Documentation should always include:

  • Reason for patient being seen
  • Subjective findings
  • Objective findings
  • Assessment of the problem, including the diagnosis
  • Body part or area where treatment is being provided (i.e Thoracic)
  • If billing time-based code, must include the time being spent for treatment
  • Any restrictions should be clearly outlined
  • Follow-up plan identified

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