Chiropractic Handbook

 

 

 

Appendix 3 — Wisconsin Medicaid-Allowable Diagnosis Codes for Chiropractic Services

The following tables list the Medicaid-allowable diagnosis codes for chiropractic services from the International Classification of Diseases, Ninth Revision, Clinical Modification.

Invertebral Disc Disorders
722.0	Displacement of cervical intervertebral disc without myelopathy   Neuritis (brachial) or radiculitis due to displacement or rupture of cervical intervertebral disc   Any condition classifiable to 722.2 of the cervical or cervicothoracic intervertebral disc
722.1	Displacement of thoracic or lumbar intervertebral disc without myleopathy
722.10	Lumbar intervertebral disc without myleopathy   Lumbago or sciatica due to displacement of intervertebral disc   Neuritis or radiculitis due to displacement or rupture of lumbar intervertebral disc   Any condition classifiable to 722.2 of the lumbar or lumbosacral intervertebral disc
722.11	Thoracic intervertebral disc without myleopathy   Any condition classifiable to 722.2 of thoracic intervertebral disc

Other, Multiple, and Ill-Defined Dislocations
839.0	Cervical vertebra, closed Cervical spine, neck
839.00	Cervical vertebra, unspecified
839.01	First cervical vertebra
839.02	Second cervical vertebra
839.03	Third cervical vertebra
839.04	Fourth cervical vertebra
839.05	Fifth cervical vertebra
839.06	Sixth cervical vertebra
839.07	Seventh cervical vertebra
839.08	Multiple cervical vertebrae
839.2	Thoracic and lumbar vertebra, closed
839.20	Lumbar vertebra
839.21	Thoracic vertebra Dorsal (thoracic) vertebra
839.4	Other vertebra, closed
839.41	Coccyx
839.42	Sacrum Sacroiliac (joint)
839.49	Other

Next — Appendix 4 — CMS 1500 Claim Form Completion Instructions
Previous — Appendix 2 — Place of Service Codes for Chiropractic Services

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Chiropractic Services Handbook
PHC 1306, October 2004