Chiropractic Medicare P.A.R.T.

Updated: February 28, 2011
Dear Doctors and Staff,

In January 2000, the provision requiring demonstration of subluxations by x-ray was amended to allow demonstration by x-ray and/or physical examination findings. The physical examination requirements were termed P.A.R.T., an acronym for pain, asymmetry, range of motion and tissue tone.

In an effort to limit vulnerabilities in the Medicare program, the Department of Health and Human Services (HHS) conducted a study of 400 Chiropractic services for the year 2001. An overall error rate of 67 percent was identified. The loss to Medicare for that year was estimated to be $285 million. The HHS study found that documentation for 94 percent of Chiropractic services were lacking at least one of the supporting P.A.R.T. elements.

The demonstration of subluxation by physical examination must include documentation of at least two of the four P.A.R.T. components. One of the two minimum components must be asymmetry or range of motion. Most other third-party payers adopted the P.A.R.T. system for Chiropractic documentation to remain consistent with Medicare. P.A.R.T. documentation falls under the objective portion of another acronym, S.O.A.P. (subjective, objective, assessment and plan) which is standard for documentation of a patient's care in most fields of healthcare.

The real problem here is "if you don't do things the correct way, it will come back and bite you!" Because a Chiropractic group decided to do away with x-rays in Medicare, now 67% of the Chiropractors can't seem to prove a subluxation using P.A.R.T. We lost big time with the "Demonstration Project". Chiropractors did not have this problem when x-rays were the only requirement for a subluxation.

There are two things we Chiropractors must do to make a Medicare claim payable:

1. Take x-rays on your Medicare patients each 12 months. (P.A.R.T. is weak, must be done each visit and can be challenged by the carriers.)

2. Document the Chiropractic Necessity of Care with a "document". (Not S.O.A.P. notes.)
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street

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