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Chiropractic care is widely recognized as a safe and non-invasive treatment for neuro-muscular conditions. Reports suggest that about 30 million Americans turn to chiropractic treatment each year. In fact, chiropractic practitioners are recognized as the third largest group of professionals who treat patients directly, after doctors and dentists. Several factors such as day-to-day routines, aging, increased body weight and other problems can affect the musculoskeletal system, causing severe pain in the joints and other problems. Typically, chiropractic treatment is used as a pain relief alternative for muscles, joints, bones and connective tissues (like ligaments, cartilage and tendons). In certain cases, it is used in combination with other conventional forms of treatment. Several changes in Medicare and private payer insurance requirements and regulations have increased the complexity of chiropractic medical billing and coding. Chiropractors need to revamp their billing workflows to submit accurate claims, reduce claim denials and get proper reimbursement.

The basic idea behind chiropractic treatment is to enable a person’s body to function better by reducing their symptoms naturally. Chiropractors utilize a combination of chiropractic adjustments, electronic muscle stimulation, laser therapies, therapeutic massage and other alternative methods (like stretches and exercises) for pain management and long-lasting relief. These treatment approaches ensure proper alignment of the body’s musculoskeletal structure by allowing it to heal itself without surgery or other medications.

Top Conditions That Chiropractors Treat and Their ICD-10 Codes

Here discussed are some top conditions that chiropractors treat and their ICD-10 codes –

Tennis Elbow – Tennis Elbow (also known as lateral epicondylitis) is a condition that causes pain outside the elbow when the tendons of the forearm muscles attach to a bony bump on the outside of the elbow. Pain can spread from the forearm to the wrist. The condition occurs when tendons in the elbow become overloaded, usually due to repetitive motions of the wrist and the arm. Symptoms include -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. Treatment involves a combination of modalities like ice packs, and non-steroidal anti-inflammatory medications, physical therapy, steroid injections, ultrasound therapy and shock wave therapy.

ICD-10 codes to report diagnosis of Tennis Elbow

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

Migraine Headaches – A neurological condition, migraine causes 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. Migraine attacks can last for hours to days and the pain can be severe enough to interfere with day-to-day activities. Migraine headaches often begin in childhood, adolescence or early adulthood and can progress through four stages – prodrome, aura, attack and post-drome. In fact, women are about three times more likely than men to experience migraines. The exact cause of this condition is not fully known. However, changes in the brainstem and its interactions with the trigeminal nerve play an active role. Also, genetics and environmental factors appear to play a role.

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

Scoliosis – A chronic spine condition, scoliosis results in abnormal lateral curvature of the spine. Affecting any part of the spine, but the most common regions are the chest area in the thoracic and thoracic-lumbar regions. Even though people of all age groups can develop scoliosis, the condition is often diagnosed in childhood or early adolescence. It is typically seen in children aged 10-12 years and is more common in girls than in boys. The symptoms vary depending on the type and degree of scoliosis. Common symptoms include – uneven shoulders/ hips/waist, a rotating spine, back/knee pain, chronic fatigue and future spinal kyphosis (widow’s hump) and one side of the rib cage jutting forward.

ICD-10 codes include –

  • M41 Scoliosis
  • M41.0 Infantile idiopathic scoliosis
    • M41.02 …… cervical region
    • M41.03 …… cervicothoracic region
    • M41.04 …… thoracic region
    • M41.05 …… thoracolumbar region
    • M41.06 …… lumbar region
    • M41.07 …… lumbosacral region
    • M41.08 …… sacral and sacrococcygeal region
  • M41.1 Juvenile and adolescent idiopathic scoliosis
  • M41.2 Other idiopathic scoliosis
  • M41.3 Thoracogenic scoliosis
  • M41.4 Neuromuscular scoliosis
  • M41.5 Other secondary scoliosis
  • M41.8 Other forms of scoliosis
  • M41.9 Scoliosis, unspecified

Fibromyalgia – Fibromyalgia is a condition that causes widespread body pain in the muscles and soft tissues surrounding the joints throughout the body. The condition does not cause joint or muscle inflammation and damage, but it can increase a person’s feelings of joint of muscle pain. Reports suggest that around 5 million adults aged 18 years or above in the United States experience fibromyalgia. In fact, most fibromyalgia cases are diagnosed in females than males. The condition causes a constant dull ache that tends to last for at least three months. Other symptoms include – joint and muscle stiffness, headaches, irregular sleep patterns, tingling and numbness in the hands and feet and trouble focusing or paying attention.

ICD-10 code to report fibromyalgia-

  • M79.7 Fibromyalgia

Carpal Tunnel Syndrome (CTS) – Carpal tunnel syndrome (CTS) is the compression on the median nerve within the wrist. The median nerve provides sensation to the thumb, index finger, long finger and part of the ring finger. CTS can occur in one or both of the hands in people who are engaged in jobs that involve repetitive use of fingers. Key symptoms include – tingling sensation, numbness or pain in the fingers, weakness or decreased feeling in the fingertips, difficulty using the hand for small tasks, and dropping small objects.

ICD-10 codes for CTS 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

Knowing the correct ICD-10 diagnosis codes related to documenting different conditions that chiropractors treat can be challenging. Chiropractic billing services provided by a professional medical billing and coding company can help ensure accurate and timely medical claim submissions and accurate reimbursement.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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