Top 5 CPT Codes and Modifiers for Chiropractic Medical Billing

It is pretty challenging to run chiropractic practice as it tends to take relatively longer to process the treatments, and in the wake of the same, the other essential tasks go unnoticed. Effective chiropractic medical billing and coding practices share several elements in common. This includes a properly trained staff, proper coding and documentation, deft practice management, and a healthy accounts receivable, taking care of ICD10/CPT Coding services amongst a lot more.

What is CPT?

 The American Medical Association is responsible for mainly publishing and maintaining the Chiropractic CPT Codes and specifications. These codes are considered some of the essential principles for chiropractors, and they have to become familiar with the same. All the CPT codes tend to feature five alpha-numeric characters, which describe evaluations, diagnostic tests, and medical procedures. All of them are performed either by a doctor or a chiropractor on a patient. The codes tend to contain tens of thousands of medical procedures as they are huge.

CPT codes make an integral part of the entire chiropractic billing process. Chiropractic billing codes tell the insurance company what procedures the chiropractor is performing and would like to be reimbursed for. Insurance companies use CPT codes to track health data and measure specific medical procedures’ prevalence and value.

Some of the standard CPT codes include:

  • CPT Code 99203 – Initial Exam
  • CPT Code 97110 – Therapeutic Exercise
  • CPT Code 98940 Chiropractic manipulative treatment (CMT); Spinal, 1-2 regions
  • CPT Code 97035 – Ultrasound/ Phonophoresis
  • CPT Code 97161 – PT Evaluation: Low Complexity

Here you can learn about some fantastic Chiropractic Medical Billing Services:

  • Billing System Enrollment-

The experts help the patients enroll in the billing system as soon as they sign up for a consultation. They ensure that all the details have been captured correctly and the regulations are also met. It includes information and demographic capture.

  • Patient Verification-

The experienced professionals or medical coders perform in-depth patient verification using proprietary tools and software when they do chiropractic medical billing. They also ensure that they remove the patients who have bad payment history, irregular insurance information, or other issues.

  • Chiropractor Coding-

Besides tracking the patient’s medical history, coding helps in receiving insurance payouts on time. It is challenging to determine the medical codes for chiropractors, and it takes a lot of time. So one can also consider outsourcing the same, so as to be relieved of the lengthy process.

  • Medical Billing and Account Reconciliation-

The step-by-step process assures that charges are mentioned correctly so insurance companies can deal efficiently in terms of payout.

  • Accounts Receivable Collections-

The professionals ensure that balances are appropriately checked, and there are follow-ups regularly when it comes to outstanding payments.

Some of the tips for Chiropractic Billing Codes:

There is nothing surprising to know that chiropractic billing can be challenging, but the reimbursements can happen successfully with perfect CPT codes.

Firstly, you need to understand the insurance coverage of the patient. For example, there can be a possibility of two patients having a similar policy, but their cases are pretty different. One insurance carrier can reimburse the same while the other cannot when it comes to CPT codes, so you need to check the claim cycle’s eligibility criteria.

Before starting any treatment, one needs to complete the pre-authorization. And if you fail to do so, then there are chances of your claim being denied. Lastly, you need to analyze the denied claims so you can get an idea of how to correct them.  Above all, one can use the tips given here.


There is a lot that goes into managing and maintaining Chiropractic Billing well in place. In such a scenario, an organization can opt for outsourced medical billing services, which will help them in streamlining their operations and also concentrate on core activities. 24/7 Medical Billing Services is a renowned medical billing service providers who can effectively handle all your chiropractic billing needs and claim settlements. For more information call us at +1-888-502-0537.

Read More: 3 Common Mistakes while Submitting Claims for Chiropractic Billing

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