Texas Administrative Code

Texas Administrative Code

TITLE 1	ADMINISTRATION
PART 15	TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 354	MEDICAID HEALTH SERVICES
SUBCHAPTER A	PURCHASED HEALTH SERVICES
DIVISION 4	MEDICAID CHIROPRACTIC SERVICES
RULE §354.1051	Additional Claim Information Requirements

In addition to the general requirements in §354.1001 of this title (relating to Claim Information Requirements), the following information is required on chiropractic claims:

(1) The diagnosis of subluxation which specifies the level and condition (acute or chronic).

(2) Location of subluxation. The precise level of the subluxation must be specified to substantiate a claim for manipulation of the spine. This designation is made in relation to the part of the spine in which the subluxation is identified. The level of subluxation may be specified in the following ways:

(A) The exact bones may be listed.

(B) The location may be used if it implies several bones.

(3) Place of service.

(4) The type of each treatment procedure.

(5) The individual charge for each authorized service related to a major diagnosis.

(6) Number of manual manipulations that have been performed.

Source Note: The provisions of this §354.1051 adopted to be effective September 21, 1976, 1 TexReg 2474; amended to be effective May 30, 1977, 2 TexReg 1929; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; amended to be effective January 10, 2001, 26 TexReg 199; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective September 1, 2003, 28 TexReg 7286