Chiropractic Services

Topics	Documentation Requirements	Forms & Publications	Provider Request for Adjustment (M6) form
Chiropractic Services	Prior Authorization Requirements	First Report of Injury (FROI) Form	Chiropractic Progress/Final Report (C25)
Claim Information	Orthopedic Chiropractic Consultants (OCC)	Capability Assessment form (C3)
Subsequent Treatment		Medical Services Dispute Resolution Request (M2)

Documentation requirements
Documentation should provide detailed information on treatment being provided and is required to be typed. Information that should always be included:

Reason for patient being seen
Subjective findings
Objective findings
Assessment of the problem, including the diagnosis
Body part or area where treatment is being provided (i.e Thoracic)
If billing time-based code, must include the time being spent for treatment
Any restrictions should be clearly outlined
Follow-up plan identified