AMA Clinical Examples in Radiology - 2008 Bulletin 1
CMS Scraps Chiropractor Exception
CMS Scraps Chiropractor Exception As of January 1, 2008, radiologists are no longer able to order x-rays for Medicare patients referred to them by chiropractors. The 2008 Medicare Fee Schedule Final Rule eliminated the "chiropractor exception," which allowed nontreating physicians, such as radiologists, to order diagnostic tests at a chiropractor's request to identify a subluxation of the spine. Before January 1, 2000, the law required that an x-ray confirm a subluxation diagnosis before Medicare would reimburse for chiropractic adjustments to correct subluxations. Radiologists, however, did not qualify under Medicare rules as treating physicians who could order xrays, nor...
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Article Overview
This article covers a CMS Medicare policy update that changed how diagnostic tests tied to chiropractic care are handled, along with the background behind the prior exception and the agency’s reasoning. It also references the American Chiropractic Association’s opposition, CMS’s response, and a chiropractic services demonstration project in several states. The piece is relevant to coders, compliance staff, radiology practices, and chiropractic providers who need to understand how Medicare policy changes can affect ordering and reimbursement workflows.
Why This Topic Matters
Policy changes in Medicare can alter who may order diagnostic services and whether related tests are payable. Understanding this update helps affected practices avoid billing and compliance errors and stay current with CMS guidance.
Article Sections
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CMS Scraps Chiropractor Exception
Introduces the Medicare policy change and the general background for why the exception had existed. Summarizes the shift in CMS reimbursement policy for diagnostic testing tied to chiropractic care.
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Stakeholder Comments and CMS Response
Reviews the positions raised during rulemaking and CMS’s response to those comments. Covers the broader issue of how the agency viewed diagnostic test use in relation to chiropractic services.
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Chiropractic Services Demonstration Project
Describes the CMS demonstration project and the states involved. Notes the project timeline and the types of services it evaluated.
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Reference
Lists a regulatory reference cited by the article.
What You Will Learn
- The Medicare policy background behind the chiropractic-related diagnostic testing exception
- How CMS responded to comments from chiropractic stakeholders
- What the chiropractic services demonstration project evaluated and where it was implemented
- Which regulatory reference is associated with the policy discussion
Who Should Read This
- Medical coders
- Radiology billing staff
- Chiropractic office staff
- Compliance professionals
- Revenue cycle professionals
- Health care administrators
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