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Wednesday, August 24, 2011

P.A.R.T. Exam, X-ray, and the Demonstration of Subluxation

One of the requirements for the initial visit is the diagnosis of a subluxation that corresponds to the symptoms the patient demonstrates.  In other words, these symptoms must bare a direct relationship to the level of subluxation. The diagnosis of subluxation can be made either by a dated x-ray or by a physical exam noting 2 of the 4 following criteria to support a manually demonstrated subluxation:
  1. Pain/tenderness evaluated in terms of location, quality and intensity.

  2. Asymmetry/misalignment identified on a sectional or segmental level.

  3. Range of motion abnormality (changes in active, passive and accessory joint movements resulting in an increase or a decrease of sectional or segmental mobility.)

  4. Tissue, tone changes in the characteristics of contiguous or associated soft tissue, including skin, fascia, muscle and ligament.

**One of the two criteria documented must be either asymmetry or range of motion
I strongly suggest doing spinal x-rays a minimum of once each year, instead of P.A.R.T.  Using your x-rays to determine subluxation is never challenged, where as anyone can challenge the findings of a subluxation with P.A.R.T.
If you have no x-ray of the area you adjusted, less than one (1) year old, you must do a P.A.R.T. form each Chiropractic visit.  Even if some of your examinations consist of the same procedures as in P.A.R.T., you must have a P.A.R.T. form each visit.  When you have current x-rays of your Medicare patient, no P.A.R.T. form is necessary.  P.A.R.T. should be placed in Item #19 on the claim form to tell the Medicare carrier you are using P.A.R.T. with this patient.


  1. Thank you for the info. It sounds pretty user friendly. I guess I’ll pick one up for fun. thank u

    Medicare Risk Adjustment Coding

    1. Thank you for your comment. Have a great weekend!


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