Chiropractic documentation gap analysis

Recognize what’s missing to master your reimbursement and collections!

This Documentation Gap Analysis allows us to evaluate the significant components of your current Documentation program. It should take less than 5 minutes to complete.

Take The Billing GAP Analysis

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This course explains the significant role chiropractic care can play in the sports industry and how a DC can succeed as a Sports Chiropractor. Start your steps to success here!

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The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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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
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KMC program is totally worth it. They helped us figure out a better system to bill insurance. Rebecca was super nice and helpful! Our clinic is finally getting paid on insurance claims. Thank you for all your help!

Isabel G.