Medicare’s Guidance for the PART Process of Identifying a Subluxation
Document in a manner that gets you reimbursed by third-party payers who want to see objectively measurable data. That’s where PART comes in:
P= Pain or Tenderness: Pain elicited during the course of the examination, described in terms of location, quality, and intensity
- Observed facial expressions of pain/discomfort
- Antalgic postures and movements
- Grooming deficiencies that could be due to pain limitations
- Mood
- Overt pain behaviors
- Pain scales
- Pain diagrams and drawings
- Functional questionnaires (outcomes assessments)
- Pain resulting from static palpation
- Pain resulting from motion palpation
- Pain reported duration regional and/or segmental ROM
- Pain reported during physical, orthopedic, neurological and/or chiropractic examination procedures
A= Asymmetry or Misalignment: Asymmetry or misalignment may be described at the regional or segmental level
- Observable regional asymmetry (posture/scoliosis screening)
- Observed local asymmetry (static palpation)
- Antalgic posture
- Gait abnormalities
- Functional or anatomical leg length discrepancies
- Muscle atrophy and asymmetry
R= Range of motion abnormality: Abnormal range of motion, either hypermobility or hypomobility, may be described at the segmental or regional level; instruments that quantify range of motion or estimates are allowable
- Active ROM
- Passive ROM
- Resisted ROM
- Segmental motion palpation
- Joint fixation (hypomobility)
- Joint laxity (hypermobility)
- Joint crepitus
- ROM measuring devices
T= Tissue tone changes: Describe changes in the tone of the soft tissue such as muscles, tendons, fascia, skin, and ligaments.
- Observable hypertonicity, spasm, hypotonicity, and atrophy
- Fasciculations
- Edema
- Bruising, discoloration
- Heat
- Muscle-tendon crepitus
- Muscle weakness
- Heat measuring instruments
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