Helpful tips about common Chiropractic Procedure Codes 97012 and 98940-98942.

Chiropractic documentation and billing codes can be very confusing for chiropractors and their billing staff. Keeping track of which codes to use and when, why some raise red flags, and why others result in denials can be extremely trying. Fortunately there are many resources available on the internet, as well as books and seminars, to help familiarize yourself with common codes needed for a Chiropractic practice. One of the most common denial issues involved 97012 and 98940-98942 on the same visit.

Some payers are denying Mechanical Traction (CPT Code 97012) on the same date of service as the Chiropractic Manipulative Treatment (CMT 98940-98942) with various rationales, the most common being that they are redundant. Obviously this is not true as 97012 does not require attendance. CMT services are in a different section of the CPT code book and are unique manual techniques that require physician attendance. I recommend refusing to accept the denial and file an appropriate appeal.