Medicare’s Medical Necessity Reference Documents

Download Reference Documents Medicare publishes helpful documents and alerts to keep providers in the know about important topics. Included here are several documents that relate specifically to Chiropractic care and medical necessity. These tools relate to the proper use of the AT Modifier, Chiropractic documentation and the overall rulebook for Medicare policy, The Benefit Policy...
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FAQ-Medicare Active vs. Maintenance Care

Active vs. Maintenance Care FAQs Q: If a Medicare patient moves from Medical Necessity treatment to Wellness and we have him/her sign an ABN, are we required to continue to bill Medicare with the appropriate modifier or can we convert the patient to cash? A: The ABN offers three options at the bottom of the...
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Medicare’s Definition of Medical Necessity

The essence of medical necessity in Medicare is being able to prove that a subluxation exists, since the only coverage for chiropractic treatment is manual manipulation of the spine to correct a subluxation. However, a subluxation that is not associated with a secondary neuromusculoskeletal condition, and/or is not causing a loss of function may not...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.