CPT code 98943: Chiropractic Manipulative Treatment (CMT), extraspinal regions

Learn how to use CPT code 98943 with our guide that has a list of documentation requirements, billing guidelines, and FAQs.

Use Code

What is the 98943 CPT code?

CPT code 98943 refers to chiropractic manipulative treatment (CMT), involving one or more regions, extraspinal. To elaborate this code, often used by healthcare providers in a chiropractic practice, pertains the specific chiropractic service of manual manipulation of extremities such as the head region, arms, hands, legs, feet. etc.

CPT code 98943 documentation requirements

In order to support the use of CPT code 98943 and to avoid denials, the following key elements must be present in your patient's records:

Patient history and chief complaint
Objective findings to justify medical necessity (e.g., decreased range of motion, joint restriction)
Specific condition or diagnosis for each treated region
Description of technique and treatment rationale
Clear documentation of extraspinal regions treated (e.g., right shoulder, left knee)
Patient's response to the treatment

CPT code 98943 billing guidelines

To ensure accurate chiropractic coding and billing, the following guidelines must be considered and kept in mind:

Used only once per patient encounter regardless of the number of extremity adjustments.
98943 should not be reported with 98940–98942, spinal adjustment codes, for the same anatomical region.
May be reported with spinal CMT codes when distinct and separately identifiable extraspinal regions are treated.
Use modifier -25 on E/M services provided on the same day if medically necessary and separately documented.
When it come to billing, Medicare generally doesn't reimburse for 98943. Confirm this with payer policies.