PART Documentation

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