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Good Morning
12:16:57 AM CDT
Monday, May 25, 2015

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Treating injured worker left Header Treating injured worker right Header
Chiropractic Treatment

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.

If concerns arise 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 WSI at 701-328-3800 or 800-777-5033.

Chiropractic Window Period and Authorization
Each claim has one window period for chiropractic treatment. The window period encompasses all body parts accepted on a claim.

The chiropractic window period is:
  • 12 visits or 90 days of care, whichever comes first
  • Modalities are limited to two per visit
  • Prior Authorization is required for treatment extending beyond the window period

Chiropractic Authorization and Referrals includes detailed information on submitting a prior authorization request.

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