Chiropractic Billing Codes A Complete Guide to CMT, ICD-10, and CPT Codes

The most used chiropractic CPT codes include 98940 (1–2 spinal regions), 98941 (3–4 regions), and 98942 (5 regions) for chiropractic manipulative treatment (CMT). Additional codes like 97010 (hot/cold packs) or 97110 (therapeutic exercises) may also be used.

CPT 98940 is used for chiropractic spinal devious treatment including 1–2 regions of the spine. It must be medically necessary and properly documented.

Common ICD-10 codes include:

• 5 (low back pain)
• 2 (Cervicalgia)
• 01–M99.05 (segmental dysfunction by region)
  Codes must match the regions treated and justify medical necessity.

Maintenance care is usually not covered by insurance and should not be billed using therapeutic CPT codes. Use modifier GA or GY when submitting non-covered services for Medicare patients.

Yes, chiropractors can bill evaluation and management (E/M) codes when a separate and significant history, exam, and decision-making process is documented. Modifier 25 may be needed when billed with CMT codes.

You must document initial exam findings, diagnosis codes, treatment plan, regions adjusted, techniques used, patient progress, and re-evaluations. Absence of documentation is a common reason of denials.

CMT codes (98940–98942) are region-based, not time-based. The code selection depends on how many spinal regions were treated during the session.

Yes, common modifiers include:

• AT – Active treatment (for Medicare)
• 25 – Separate E/M service
• 59 – Distinct procedure
• GA/GY – Medicare non-covered services