CPT Code 98941 a Guide to Chiropractic Billing

Chiropractic care plays a crucial role in addressing spinal misalignments, improving mobility, and relieving musculoskeletal discomfort. To make sure proper billing and reimbursement, chiropractors use specific CPT codes, including CPT Code 98941.
This code is essential for documenting chiropractic manipulative treatment (CMT) for patients receiving care for spinal issues.

What is CPT Code 98941?

CPT Code 98941 is a billing code that is used by Chiropractors to report spinal manipulation treatment in three to four spinal areas. This code is recognized by the American Medical Association (AMA) and helps standardize the documentation and billing process for curiosity services.

Chiropractors use this code to report treatment aimed at correcting the sub-base, referring to the alignment of the spines that can affect the health of the overall spinal cord.

What Does CPT Code 98941 Cover?

This code applies to the manual manipulation of the spine to correct subluxations and improve spinal alignment and function. It is typically used for treating conditions such as:

Back pain
Neck pain
Restricted mobility
Other musculoskeletal disorders related to spinal misalignment

Chiropractors can use CPT Code 98941 when treating the cervical, thoracic, lumbar, sacral, and pelvic areas. However, it is important to note that the code can only be billed once per treatment session, even if multiple spinal regions are addressed.

Benefits of Using CPT Code 98941

Using CPT Code 98941 ensures that chiropractic treatments are accurately documented and billed. Some of the key benefits include:

Clear documentation of chiropractic manipulative treatment for 3-4 spinal regions.
Helps in securing proper reimbursement from insurance providers.
Standardizes the reporting process for spinal adjustment procedures.
Supports the medical necessity of chiropractic care for insurance claims.

Documentation Requirements for CPT Code 98941

Proper documentation is critical when using CPT Code 98941 to avoid claim denials and ensure compliance with chiropractic billing regulations. Chiropractors must include the following details in patient records:

Specific spinal regions treated (e.g., cervical, thoracic, lumbar)
The patient’s diagnosis justifying the treatment
Progress notes demonstrating the necessity and effectiveness of the treatment
Description of the manual manipulation techniques used

Maintaining accurate and detailed records helps chiropractors establish the medical necessity of the treatment, reducing the chances of insurance denials.

Common Challenges and Denials Related to CPT Code 98941

While CPT Code 98941 is widely used, chiropractors may face challenges in receiving reimbursements due to:

Missing or incorrect modifiers
Insufficient documentation supporting the treatment’s necessity
Denials from insurance companies, such as Humana and Medicare, due to policy restrictions

To avoid denials, chiropractors should verify payer requirements, use appropriate modifiers, and maintain thorough documentation for each patient visit.

Related Chiropractic CPT Codes

Chiropractors use additional CPT codes to report different levels of spinal manipulative treatment:

CPT Code 98940 – Used for chiropractic manipulation treatment that includes one to two spinal cords.
CPT code 98942 – Five or more spinal cord areas are used when treating.

Understanding the difference between these codes ensures compliance with accurate billing and insurance guidelines.

Final Thoughts on CPT Code 98941

CPT Code 98941 is essential for chiropractors to provide spinal manipulative treatment for patients with musculoskeletal disorders. Proper documentation and adherence to billing requirements ensure seamless reimbursement and compliance with industry standards.
Chiropractors should stay updated with payer policies, use accurate coding, and document treatment necessities to optimize the medical billing process and provide high-quality care for their patients.

Need more help?