CIGNA covers chiropractic manipulation services and adjunct therapeutic modalities if they are medically necessary. Read on about CIGNA coverage, documentation, and chiropractic services that are not covered.
1. Does CIGNA Cover Chiropractic Services?
Chiropractic manipulation and adjunct chiropractic services or mobilities (for example, traction or therapeutic exercise) are covered by CIGNA if the conditions below are met.
- The chiropractic or doctor who performed the chiropractic care is licensed and provides services within their scope as defined the state law.
- Chiropractic treatment is provided to a patient with a neuromusculoskeletal condition and aims to restore its optimal function.
- The patient is undergoing a treatment program, and CIGNA requires the following documentation.
2. Documentation For CIGNA Chiropractic Coverage
The following documentation about the treatment program is required by CIGNA for chiropractic services to be covered.
- A prescribed treatment program and the expected improvement(s).
- The timeline with a goal for therapeutic improvement.
- Demonstrated progress towards improved activity tolerances or significant functional gains.
- Long-term and short-term attainable and quantifiable goals of the treatment plan.
- The results, duration, and frequency of planned treatment.
- Diagnostic procedures.
- Diagnostic results.
- The symptoms are treated with the treatment plan.
3. Chiropractic Services Not Covered By CIGNA
According to CIGNA, the following chiropractic procedures are not covered because they are not medically necessary.
- Any duplicated chiropractic services.
- Chiropractic services are provided to patients to reduce potential health risks. The patient does not expect to gain significant improvement from the treatment plan.
- Chiropractic modalities or manipulations unrelated to the patient’s symptoms and do not result in sustained improvements or have no well-defined endpoints, including;
- supportive care;
- preventive care;
- care for preventing slow deterioration; or
- care for preventing reoccurrence.
TIP: You can find all the CPT codes for chiropractic services here.