October 3, 2011
Chiropractic Maintenance Therapy (Medicare Terminology)
Under the Medicare program, Chiropractic 'maintenance therapy' is not considered to be medically reasonable or necessary, and is therefore not payable. 'Maintenance therapy' is defined as a "treatment plan" that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or "therapy" that is performed to maintain or prevent deterioration of a chronic condition.
When further clinical improvement cannot reasonably be expected from continuous ongoing care, and the Chiropractic treatment becomes supportive rather than corrective in nature, the treatment is then considered "maintenance therapy". Chiropractic "maintenance therapy" is in direct relation to you as a Chiropractor, either "correcting" vertebral subluxations (vertebral displacements) or "treating" the patient's symptoms.
The Chiropractic Medicare program ONLY reimburses for a Chiropractor to correct vertebral subluxations. Patients symptoms help Chiropractors locate the causal subluxation, but are not the indicator as to if the subluxation has been corrected.
The Chiropractic adjustment is NOT a "treatment". The Chiropractic adjustment is a "correction". A "treatment" becomes supportive rather than corrective in nature, the treatment is then considered maintenance therapy.
The correction of a vertebral subluxation is the only payable service in Medicare for Chiropractors.
Many Chiropractors have fallen for the "treatment" of symptoms in Medicare....the patient marks option #2 on the ABN and Medicare is not billed. The patient has been cheated from Medicare coverage because the Chiropractor is "treating symptoms". Even though vertebral subluxations are being found and adjusted, since the patient had NO symptoms, the doctor now believes it is maintenance care. (The Medicare patient is probably on 10 prescription drugs from the local MD, and can't feel any symptoms.)
If the patient has vertebral subluxations, then there must be "Neuronal Components" or there is NO subluxation. If the patient has NO symptoms, then a thorough examination of this patient will indicate the prescription drugs the patient consumes for specific symptoms related to malfunction of specific body organs.
Matching the vertebral subluxations to a specific malfunction organ is simple for a Chiropractor.
Locating the subluxation, finding the Neuronal Component to a malfunctioning body organ must be documented by Federal standard "documentation". This is the way Chiropractic Medicare functions, like real Chiropractors, and not treating patient symptoms.