Clarification: August Record article about additional procedure codes payable to chiropractors

In an August Record article, we used incorrect terminology when referring to certain physical rehabilitative services payable to chiropractors. We should have written that additional procedure codes are payable to chiropractors for physical medicine services, effective Aug. 1, 2015. This change applies to groups with standard chiropractic benefits.

Due to this change, medical physicians (M.D.s or D.O.s) may be asked to agree to and sign a physical medicine treatment plan developed by chiropractors. A prescription is not required for a member to receive covered physical medicine services from a chiropractor.

This provision means that Blue Cross Blue Shield of Michigan will pay for the first physical medicine service per patient and not per visit. After the first physical medicine service is provided, Blue Cross will not pay for additional physical medicine services to the patient without the development of a physical medicine treatment plan that is agreed to and signed by the member’s M.D. or D.O.

The only exception to this requirement is for mechanical traction (procedure code *97012), which may be performed at subsequent visits without a physical medicine treatment plan. For mechanical traction, Blue Cross will maintain the current payment structure. A physical medicine treatment plan is not required for this code.

Health care providers should document the use of procedure code *97012 in the physical medicine treatment plan if mechanical traction is performed in addition to other physical medicine services. That way, the M.D. or D.O. is aware of all of the treatment the patient is receiving to help ensure coordination and quality of care.

For a list of reimbursable procedure codes, refer to the August Record article.

Note: No physician (M.D. or D.O.) agreement or signature is required on a treatment plan for MESSA members.