Software for chiropractors running thirty-visit days

Built for the pace of an adjustment schedule

A chiropractic day is not six one-hour sessions; it is thirty short visits with documentation that has to keep up with them. Software that adds two minutes per visit costs a busy practice an hour a day.

The chiropractic pack is built around that visit loop: yesterday’s note carried forward, listings updated by exception rather than re-entered, the CMT code following from the regions documented, and the charge created the moment the note is signed.

The adjustment-day toolkit

Regions treated, not minutes spent

Chiropractic manipulative treatment is coded by how many spinal regions were treated, not by how long the visit took or how many segments were adjusted. There are five spinal regions for this purpose (cervical, thoracic, lumbar, sacral and pelvic) and the code follows the count: 98940 for one or two regions, 98941 for three or four, 98942 for all five. Extraspinal manipulation is 98943, with its own five regions.

The consequence for documentation is blunt. The regions treated must be identifiable in the note, because the note is the only thing standing behind the code if anyone asks. A note that records an adjustment without saying which regions were involved does not support the higher-region code, and “the patient knows what I did” is not a defence on review.

Two things practices lose money or sleep over here:

Medicare covers manual manipulation only, and only to correct a subluxation. X-rays, massage and acupuncture a chiropractor orders are not covered by Part B. The record must identify the level and show that treatment is corrective rather than maintenance, and the AT (active treatment) modifier is how the claim says so: Medicare requires it to pay 98940, 98941 or 98942, and it must be left off once care has become maintenance. Maintenance care is the patient’s cost, and saying so before the visit rather than after is the difference between a routine payment and an argument.

An E/M on the same day is separately reportable only when it is genuinely separate. Every adjustment includes an assessment; that assessment is part of the manipulation and is not a second billable service. A separately identifiable evaluation (a new complaint, a re-evaluation driving a change in the plan) can be reported alongside with the appropriate modifier, and payers scrutinise this pairing closely enough that the note should make the separateness obvious on its face rather than by implication.

In MegAligna the CMT code on a charge is the one recorded for the visit, with the rendering provider attached. It does not pick the code from the regions, and it does not append AT: the only modifiers it adds are the credential and telehealth modifiers you configure per payer. Whether a given visit is active or maintenance care is a clinical call made visit by visit, so the clinician documents it and the biller adds AT where it applies. A system that appended AT to every Medicare visit by default would be asserting active treatment on visits that were not.

Cash visits without a dummy payer

Cash chiropractic runs on per-visit fees, packages and memberships, which sit badly in insurance-shaped systems: practices end up creating a dummy payer and posting $0 claims to make the visit record balance.

A cash visit here is a charge in its own right with a card payment against it. There is no dummy payer and no $0 claim, and reporting separates cash revenue from insurance-pending revenue rather than mixing them in one collections figure. Prepaid packages and memberships are not built yet.

Three incumbent comparisons cover the vendors most chiropractic practices evaluate: ChiroTouch, Platinum Software and Genesis. For patients who self-submit, the superbill template covers what the document has to carry.