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Chiropractic manipulative treatment (CMT) is a therapeutic procedure that involves the application of controlled, sudden force and twisting movements to the spine and extraspinal regions. The primary goal of CMT is to relieve pressure on the spinal nerves, reduce inflammation, and enhance overall nerve function. This treatment modality can be utilized independently or in conjunction with various supportive therapies, including exercise regimens, lifestyle modifications, nutritional counseling, trigger point massage, electrical muscle stimulation, and ultrasound therapy. CMT is particularly beneficial for patients experiencing a range of conditions such as back and neck pain, headaches, fibromyalgia, sciatica, myofascial pain, spinal stenosis, and chest wall discomfort. The specific CPT® code 98942 is designated for CMT that addresses five regions of the spine, distinguishing it from other codes that correspond to fewer regions treated. For instance, code 98940 is applicable for CMT in one to two regions, while code 98941 is used for three to four regions. Additionally, code 98943 is reserved for CMT performed in one or more extraspinal regions, highlighting the comprehensive nature of chiropractic care in addressing musculoskeletal issues.
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The indications for chiropractic manipulative treatment (CMT) using CPT® code 98942 include a variety of conditions that affect the spine and surrounding areas. These conditions may lead to discomfort and functional limitations, prompting the need for intervention through CMT. The following are explicitly provided indications for this procedure:
The procedure for chiropractic manipulative treatment (CMT) as described by CPT® code 98942 involves several key steps that are performed by a qualified chiropractor. Each step is designed to ensure the effectiveness and safety of the treatment.
Following chiropractic manipulative treatment (CMT) using CPT® code 98942, patients may experience immediate relief from symptoms, although some may have mild soreness in the treated areas. It is common for patients to be advised to rest and avoid strenuous activities for a short period after the procedure. The chiropractor may recommend a follow-up appointment to monitor progress and determine the need for additional treatments. Patients are also encouraged to engage in prescribed exercises and lifestyle modifications to support recovery and enhance the benefits of CMT. Overall, the expected recovery time can vary based on individual conditions and the extent of treatment received.
| Short Descr | CHIROPRACTIC MANJ 5 REGIONS | Medium Descr | CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS | Long Descr | Chiropractic manipulative treatment (CMT); spinal, 5 regions | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | O1B - Chiropractic | MUE | 1 | CCS Clinical Classification | 163 - Other non-OR therapeutic procedures on musculoskeletal system |
| AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | GA | Waiver of liability statement issued as required by payer policy, individual case | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | AR | Physician provider services in a physician scarcity area | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 96 | Habilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for habilitative purposes, the physician or other qualified health care professional may add modifier 96 to the service or procedure code to indicate that the service or procedure provided was a habilitative service. habilitative services help an individual learn skills and functioning for daily living that the individual has not yet developed, and then keep and/or improve those learned skills. habilitative services also help an individual keep, learn, or improve skills and functioning for daily living. | 97 | Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled. | 99 | Multiple modifiers: under certain circumstances 2 or more modifiers may be necessary to completely delineate a service. in such situations modifier 99 should be added to the basic procedure, and other applicable modifiers may be listed as part of the description of the service. | A1 | Dressing for one wound | AE | Registered dietician | AG | Primary physician | AI | Principal physician of record | AV | Item furnished in conjunction with a prosthetic device, prosthetic or orthotic | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | EP | Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program | G8 | Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure | GP | Services delivered under an outpatient physical therapy plan of care | GR | This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item | KX | Requirements specified in the medical policy have been met | PA | Surgical or other invasive procedure on wrong body part | QA | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm) | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | ST | Related to trauma or injury | TA | Left foot, great toe | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| 1997-01-01 | Added | First appearance in code book in 1997. |
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