General Information
Documentation Requirements
All providers, including chiropractors, are required to prepare and maintain truthful, accurate, complete, legible, and concise documentation and medical and financial records, according to HFS 106.02(9)(a), Wis. Admin. Code. This includes documenting all new spells of illness (SOI) in the recipients medical record. HFS 107.15(3)(b), Wis. Admin. Code, defines an SOI as one of the following:
- An acute onset of a new spinal subluxation.
- An acute onset of an aggravation of pre-existing spinal subluxation by injury.
- An acute onset of a change in a pre-existing spinal subluxation based on objective findings.
The initial visit and 20 manipulations per provider per SOI do not require PA. Prior authorization is needed for more than 20 manipulations per SOI. Refer to the Prior Authorization chapter of this handbook for further PA information.
Next Documentation Requirements, Reviews and Audits
Previous Recipient Information, Wisconsin Medicaid HMO Coverage
Chiropractic Services Handbook
PHC 1306, October 2004