From ABNs to Z-Codes: Your Clinic’s Year-End Compliance Review and New Year Checklist

Year-End Chiropractic Compliance Checklist: What to Review Before the New Year

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The holiday season brings two familiar realities for chiropractic practices: reminders about “use it or lose it” benefits and the need to wrap up your year-end chiropractic compliance checklist. Instead of rushing through December, use this time as a strategic review, your end-of-year compliance game film.

This year-end chiropractic compliance checklist helps you identify gaps, reinforce best practices, and step into the new year audit-ready and confident.

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ABNs: The Foundation of Patient Financial Clarity

The Advance Beneficiary Notice of Noncoverage (ABN) plays a critical role in Medicare compliance. It documents that a patient understands certain services may not be covered and agrees to financial responsibility.

Year-End Action Step:

Pull a random sample of 10 Medicare patient files from the past six months.

What to Check:

• Was the ABN delivered and signed before providing non-covered services, such as maintenance care?
• Is the form complete, current, and properly worded?

How to Fix Issues:

If you find unsigned, outdated, or incomplete ABNs, address it now. Retrain your team and reinforce when and how ABNs must be used. In an audit, an invalid ABN offers no protection.

Documentation Depth: Strengthening Medical Necessity

Your documentation tells the only story an auditor will ever read. Therefore, it must clearly explain why care was necessary and how the patient progressed.

Year-End Action Step:

Review recent discharge notes or cases that extended beyond 12 weeks.

What to Check:

• Do your SOAP notes show measurable improvement in functional goals?
• Does the plan of care evolve based on patient response, or does it rely on copied text?

How to Fix Issues:

Focus on the measurable and assessable portions of your notes. Eliminate copy-and-paste habits and reinforce documentation that supports medical necessity. A proactive chart review can help identify risks before they become problems.

Coding Confidence: From CPT Codes to ICD-10 Specificity

While CPT codes describe what you did, ICD-10 codes explain why you did it. Both must align.

Year-End Action Step:

Review claims that were denied, delayed, or questioned this year.

What to Check:

• Are diagnosis codes specific and accurate?
• Are unspecified codes used when more precise options exist?

How to Fix Issues:

Set aside time to review ICD-10 and CPT updates that took effect this year. Staying current reduces denials and lowers audit risk.

Financial Policies & “Use It or Lose It” Conversations

As the year closes, financial policies deserve just as much attention as clinical documentation.

Year-End Action Step:

Review your fee schedule and front-desk communication process.

What to Check:

• Is your fee schedule consistent and up to date?
• Can your team confidently and compliantly discuss deductibles, HSAs, and FSAs?

How to Fix Issues:

Create a clear, compliant script for year-end benefit reminders. These conversations should educate patients without overpromising coverage. Done correctly, they improve patient experience and cash flow.

Your New Year Chiropractic Compliance Checklist

Before the new year begins, complete these final steps:

• Review Compliance Policies: HIPAA, OIG, BAAs, and financial policies should reflect how your practice operates today.
• Schedule Required Training: Plan annual HIPAA and Fraud, Waste & Abuse (FWA) training early.
• Know Your Auditors: Keep Medicare and payer contact information accessible.
• Update Forms: CMS updates the ABN every three years. The current version expires January 31, 2026—watch the CMS BNI page for updates.

Start the New Year Prepared

A focused year-end chiropractic compliance review helps you leave penalties behind and move forward with clarity and confidence. By addressing ABNs, documentation, coding, and financial policies now, you set your practice up for a smoother, safer, and more successful year ahead.

By closing out the year with a focused compliance review, you ensure that you leave potential penalties in the past and start next year with the clarity and confidence to grow your practice!

KMC University regularly helps chiropractic practices like yours with a year-end chiropractic compliance checklist review through a Proactive Chart Review. If you are unsure or would like support,  Schedule a Free Discovery Assessment! Our specialists are ready to guide you.

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Dr. Erin Stubblefield graduated from Palmer College of Chiropractic in Davenport, IA in 2006. After practicing privately, she transitioned to Chiropractic education for 13 years before joining KMC University as a Specialist in 2024. Currently, Dr. Stubblefield is the owner of Sunflower Consulting, LLC, a healthcare consulting and practice coaching group. Dr. Stubblefield partners with KMC to provide accurate, current, and compliant information. For further information, you can reach her at drerin@kmcuniversity.com