Chiropractic Treatment

A chiropractor may be the treating provider 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

For initial chiropractic treatment with a date of service on or after January 1, 2018, WSI allows one window period.  WSI defines the window period as a period of initial chiropractic treatment on a claim not requiring prior authorization.  Treatment occurring outside the window period, a chiropractor will need to complete the Utilization Review Chiropractic (UR-Chiro) form.  This includes treatment initiated prior to January 1, 2018, treatment extending beyond the window period, and palliative care.

Palliative Care

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.

Prior Authorization

Chiropractic Authorization includes detailed information on prior authorization requirements and procedures for submitting a prior authorization request.

Resources

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.