A chiropractor may be the treating practitioner of record for an injured worker. Treatment parameters and prior authorization guidelines are applicable for all chiropractic services, including referrals.
Evaluation and Management Services
A chiropractor may complete an evaluation and management (E&M) service, when medically necessary to treat a work injury, without prior authorization.
Acute/Subacute Chiropractic Care
With the exception of treatment completed during the initial evaluation, a chiropractor is required to obtain prior authorization for manipulations, therapeutic procedures, and modalities. Effective July 1, 2016, WSI began a pilot program which discontinues the previously allowed window period of 12 visits or 90 days for chiropractic treatment.
Palliative care may be medically appropriate after the worker has reached maximum medical improvement (MMI). Requests for prior authorization of palliative care must include the completed palliative care questionnaires.
Chiropractic Authorization includes detailed information on prior authorization requirements and procedures for submitting a prior authorization request.
The Quick Reference for Chiropractors contains additional information related to chiropractic treatment and authorization requirements.
If a concern arises during treatment of an injured worker, e.g. the injured worker not attending appointments, symptoms not consistent with the injury, cancellation of medical appointments, or noncompliance with treatment plan, contact Customer Service at 701-328-3800 or 800-777-5033.