Chiropractic care is widely recognized as one of the safest, drug-free and non-invasive therapies available for the treatment of neuro-musculoskeletal complaints. Day-to-day hurdles of life can put demands on your musculoskeletal system causing painful joints and other problems. Generally, chiropractic treatment is used as a pain relief alternative for muscles, joints, bones and connective tissues (like ligaments, cartilage and tendons). In some cases, it is used in combination with other conventional forms of treatment. About 22 million Americans are estimated to visit chiropractors annually. The main goal of chiropractic care is to allow the patient’s body to function better by reducing their symptoms naturally. Chiropractors utilize hands-on spinal manipulation and other alternative treatments. The basic theory behind this treatment approach is the proper alignment of the body’s musculoskeletal structure as this will allow the body to heal by itself without surgery or other medications. Manipulation technique is used to restore the joint mobility lost due to tissue injuries resulting from repetitive stress to the joints. With significant changes in Medicare and private payer insurance requirements and regulations, chiropractic medical billing and coding has become quite challenging. Chiropractors need to revamp their billing workflows to submit accurate claims, reduce denials and get reimbursed.

Now, here discussed are three common conditions that chiropractors treat and their ICD-10 codes –

Carpal Tunnel Syndrome (CTS) – Regarded as one of the most common problems affecting the hand, carpal tunnel syndrome (CTS) is the compression on a nerve within the wrist – called the median nerve. Located on the palm side of the hand (also called the carpal tunnel), the median nerve provides sensation to the thumb, index finger, long finger and part of the ring finger. The nerve supplies the impulse to the muscle going to thumb. People who are engaged in activities or jobs that involve repetitive use of fingers like – high force hammering, extreme wrist motions and vibration are at high risk of developing this condition. CTS can occur in either one or both of your hands and includes symptoms like – tingling sensation, numbness or pain in the fingers (especially the thumb, index and middle fingers), weakness or decreased feeling in the fingertips, difficulty using the hand for small tasks (like handling small objects, writing, holding a book to read, or using a computer keyboard) and dropping small objects. Treatment for this condition aims to ease the tingling and numbness and restore wrist and hand function. Common treatment options include – wrist splinting, medications and surgery. ICD-10 codes for diagnosing carpal tunnel syndrome include –

  • G56.0 Carpal tunnel syndrome
  • G56.00 Carpal tunnel syndrome, unspecified upper limb
  • G56.01 Carpal tunnel syndrome, right upper limb
  • G56.02 Carpal tunnel syndrome, left upper limb
  • G56.03 Carpal tunnel syndrome, bilateral upper limbs

Tennis Elbow – Tennis Elbow is a condition that causes pain outside the elbow. The pain normally occurs where the tendons of the forearm muscles attach to a bony bump on the outside of your elbow. It can also spread to your forearm and wrist. Pain is normally felt when you straighten or fully extend your arm. Also known as lateral epicondylitis, the condition arises when tendons in the elbow become overloaded, usually due to repetitive motions of the wrist and the arm. As the name suggests, the condition occurs as a result of playing tennis or other racquet sports, but can also result from other activities like swimming, golfing, turning a key, and frequently using a screwdriver, hammer, or computer. It usually affects adults and is more common in people in the age group of 40-60. Symptoms include – pain (extending from the outside of the elbow down to the forearm and wrist), severe pain when shaking hands or squeezing an object, mild elbow pain (which gets worse gradually), a weak grip and pain when lifting something, using tools, or opening jars. Diagnosis of this elbow condition is done through a physical examination wherein the physician may apply some pressure to the spot where the tendon attaches to the bone and check for pain. Treatment for this condition involves a combination of rest and other modalities like ice packs, and non-steroidal anti-inflammatory medications, physical therapy, steroid injections, ultrasound therapy and shock wave therapy. Surgery may be considered as a last resort, if symptoms do not improve even after a year of treatment. However, in most cases, about 80 to 95 percent of tennis elbow cases can be successfully treated without surgery. ICD-10 codes to report a diagnosis of tennis elbow –

  • M77.1 Lateral epicondylitis
  • M77.10 Lateral epicondylitis, unspecified elbow
  • M77.11 Lateral epicondylitis, right elbow
  • M77.12 Lateral epicondylitis, left elbow

Migraine Headaches – A neurological condition that causes multiple symptoms, migraine is characterized by intense, debilitating headache. A migraine headache can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. The pain is often followed by nausea, vomiting, and extreme sensitivity to light and sound. Generally, the migraine attacks can last for hours to days and the pain can be so severe as to interfere with your day-to-day activities. Reports from the National Headache Foundation estimate that nearly 12% of the US population experience migraine headaches (2018 statistics). In fact, women are about three times more likely than men to experience migraines. Even though the exact cause of this condition is not fully known, genetics and environmental factors appear to play an active role. However, changes in the brainstem and its interactions with the trigeminal nerve – a major pain pathway – may also play an important role. Migraine headaches often begin in childhood, adolescence or early adulthood and can progress through four stages like – prodrome, aura, attack and post-drome. However, not everyone who has this condition goes through all these stages. Common symptoms include – pounding or throbbing headache, sensitivity to light, noise and odors, loss of appetite, pale color, nausea and vomiting, feeling tired, pain that throbs or pulses, and uncontrollable jerking or other movements. Physicians may diagnose migraine based on your medical history, symptoms, and a physical and neurological examination. If the condition suddenly becomes severe, they will perform imaging tests like MRI and CT scan to rule out other causes of pain. Treatment options include pain-relieving and preventive medications. Related ICD-10 codes include –

  • G43 Migraine
  • G43.0 Migraine without aura
    • G43.00 Migraine without aura, not intractable
    • G43.01 Migraine without aura, intractable
  • G43.1 Migraine with aura
    • G43.10 Migraine with aura, not intractable
    • G43.11 Migraine with aura, intractable
  • G43.4 Hemiplegic migraine
    • G43.40 Hemiplegic migraine, not intractable
    • G43.41 Hemiplegic migraine, intractable
  • G43.5 Persistent migraine aura without cerebral infarction
    • G43.50 Persistent migraine aura without cerebral infarction, not intractable
    • G43.51 Persistent migraine aura without cerebral infarction, intractable
  • G43.6 Persistent migraine aura with cerebral infarction
    • G43.60 Persistent migraine aura with cerebral infarction, not intractable
    • G43.61 Persistent migraine aura with cerebral infarction, intractable
  • G43.7 Chronic migraine without aura
    • G43.70 Chronic migraine without aura, not intractable
    • G43.71 Chronic migraine without aura, intractable
  • G43.A Cyclical vomiting
  • G43.B Ophthalmoplegic migraine
  • G43.C Periodic headache syndromes in child or adult
  • G43.D Abdominal migraine
  • G43.8 Other migraine
    • G43.80 Other migraine, not intractable
    • G43.81 Other migraine, intractable
    • G43.82 Menstrual migraine, not intractable
    • G43.83 Menstrual migraine, intractable
  • G43.9 Migraine, unspecified
    • G43.90 Migraine, unspecified, not intractable
    • G43.91 Migraine, unspecified, intractable

Documenting and coding chiropractic disorders and the services provided require correct understanding of medical coding and insurance policies. Chiropractic billing and coding services provided by a reputable and experienced medical billing and coding company can help physicians with correct and timely claims processing that is crucial for proper revenue management.