Chiropractic

WSI requires a chiropractor obtain prior authorization for all treatment extending beyond the initial window period.  Physician referral does not waive prior authorization requirements.

Chiropractic Window Period

WSI defines the window period as a period of initial chiropractic treatment on a claim not requiring prior authorization.  A change in chiropractor during an established course of treatment does not initiate a new window period.  Each window period includes:

  • 10 visits or 60 days of care, whichever comes first, including the initial evaluation
  • Treatment of all body parts accepted on a claim
  • Up to 2 modalities per visit

WSI does not reimburse for massage or manual therapy when performed with the manipulation on the same spinal region on the same visit.

Submitting a Prior Authorization Request for Chiropractic Services

A chiropractor must request prior authorization for all treatment occurring outside the window period.  To complete a request for prior authorization:

A provider should refer to the Authorization page for information on WSI's prior authorization requirements for other medical services, e.g. durable medical equipment, radiology.

Submitting a Prior Authorization Request for Palliative Care

A chiropractor must request prior authorization for palliative care.  To complete a request for prior authorization:

For more information about services requiring prior authorization, please contact Utilization Review at 701-328-5990 or 888-777-5871.

Chiropractic Treatment includes information pertaining to the provision of chiropractic treatment.