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July 2016

Reminder: When billing chiropractic claims, include all required documentation

When chiropractors bill for procedure code *97012 and other physical therapy codes, they must include the following information in their documentation:

  • The device used to apply the therapy
  • The anatomic location of the therapy (for example, cervical, thoracic or lumbar region of the spine)
  • The time of treatment
  • The medical justification (for example, to reduce a disc bulge or reduce scarring)

This information is required for reimbursement. Also, remember that you're subject to all Blue Cross Blue Shield of Michigan documentation guidelines located on the following sites:

  • Our online Chiropractor provider manual on web-DENIS
  • The Record newsletter articles
  • Web-DENIS broadcast messages
  • The ChiroCode DeskBook for chiropractic coding, reimbursement and compliance

To locate our online Chiropractor provider manual and find billing guidelines, log in to web-DENIS and follow these steps:

  • Click on BCBSM Provider Publication and Resources.
  • Click on Provider Manual.
  • Enter the provider type and click on Search.
  • Click on Chiropractic Services.
  • Click on Billing Guidelines.
No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.