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  • CT thoughts

    Just found this on another forum, incurance carrier no longer covering cervical manipulation.

    neck manipulation coverage


    Gary

  • #2
    Originally posted by garydiny View Post
    Just found this on another forum, incurance carrier no longer covering cervical manipulation.

    neck manipulation coverage


    Gary
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    • #3
      I think the attached is the official policy. More than cervical manipulation is non-covered, but I'm not sure if those other things were always not covered.

      I found the document here
      Attached Files
      Last edited by Jon Newman; 01-09-2010, 06:29 PM.
      "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

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      • #4
        Jon,
        It looks like Kaiser already had the restriction on manipulation of at least the head, including the TMJ, before they added this restriction on cervical manipulation altogether (note the exlusion of the atlanto-occipital joint in #1.

        From the benefit coverage document Jon sited:

        Chiropractic manipulation is not indicated for the cervical spine secondary to the risk of carotid and vertebral artery dissection.

        Chiropractic manipulation is not indicated for extra spinal regions, including:
        1. Head region (including temporomandibular joint, excluding atlanto-occipital);
        2. Lower extremities;
        3. Upper extremities;
        4. Rib cage (excluding costotransverse and costovertebral joints); and,
        5. Abdomen.
        --from pp 3-4 of Kaiser Permanente's "Chiropractic Manipulation Medical Coverage Policy (Referral)"
        I like how that restriction against cervical manip. sits out there all by itself in bold. :thumbs_up

        I'm not a fan of these vertically integrated insurance/provider behemoths, but this is one of the positive aspects of these organizations where insurance administrators and providers have overlapping interests.
        John Ware, PT
        Fellow of the American Academy of Orthopedic Manual Physical Therapists
        "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
        “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
        be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

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