Chiropractic Coding & Compliance Alert

Answer: There is no need at all to use Modifier 51 (Multiple procedures) in this scenario. The beauty of CMT codes is that they already have a multiplier inbuilt into their descriptors. Code 98940 (Chiropractic manipulative treatment [CMT]; spinal, 1-2 regions) is for 1-2 regions and then the number of regions increases from there. You should only use one code as the code descriptors illustrate: 98941 (…3-4 regions), 98942 (…5 regions), and 98943 (…extraspinal, 1 or more regions).You shouldn’t use a modifier 51 with CMT.

 

Important: CMT codes are based on the regions treated, not the number of vertebrae. So if three vertebrae in two regions are treated, 98940 is the correct code and you don’t need a modifier.

 

Tip: When reporting CMT codes, remember to only report the code once when a physician performs manipulation on more than one vertebra of the same spinal region.

 

Make sure that your diagnosis supports the levels of subluxation. If you report 3-4 regions (98941) then you must have at least 3 subluxation diagnosis codes.