In chiropractic practice, accurate documentation and coding are essential for proper reimbursement, compliance, and maintaining efficient clinical workflows. One code that chiropractors frequently use, but often misunderstand, is the CPT Code 98940.
This code applies specifically to chiropractic manipulative treatment (CMT) involving a limited number of spinal regions. In this article, our team at Healthsure Hub breaks down what CPT 98940 means, how it’s used, when it applies, and how it fits into everyday chiropractic care.
What Is CPT Code 98940?
CPT Code 98940 is used to report Chiropractic Manipulative Treatment (CMT) involving only one or two spinal regions. This code reflects a hands-on spinal adjustment performed by a chiropractor to address joint dysfunction, subluxations, or neuromusculoskeletal conditions.
98940 is one of a series of chiropractic manipulation codes:
- 98940 – 1–2 spinal regions
- 98941 – 3–4 spinal regions
- 98942 – 5 spinal regions
This code only applies when treatment is directed specifically at spinal regions and when clinical documentation supports the presence of subluxation or segmental dysfunction that requires manipulation.
When Should CPT Code 98940 Be Used?
CPT 98940 should be used when all the following conditions are met:
- The chiropractor performs a spinal manipulation
- The treatment targets one or two spinal regions only
- Clinical findings support the need for the service
- Appropriate documentation of subluxation or segmental dysfunction exists
Common clinical scenarios include:
- Cervical pain requiring adjustment of 1–2 cervical vertebrae
- Lower back pain isolated to one lumbar segment
- Patients with mild or localized spinal dysfunction
If the clinician treats more than two regions, they must code 98941 or 98942 instead — using 98940 for broader treatment is a common coding mistake that can result in underbilling.
Source: Pexels
What Counts as a Spinal Region?
The chiropractic CMT codes divide the spine into five distinct regions, and correct classification is essential for accurate billing.
The five spinal regions are:
- Cervical – including the atlas
- Thoracic – including ribs
- Lumbar
- Sacral
- Pelvic
For CPT code 98940, treatment must involve no more than two of these regions. For example:
- Cervical only (1 region) → 98940
- Cervical + thoracic (2 regions) → 98940
- Cervical + thoracic + lumbar (3 regions) → 98941, not 98940
Correct region counting helps ensure appropriate and compliant reimbursement.
Documentation Requirements for CPT Code 98940
To bill CPT 98940 appropriately, chiropractic documentation must support both the medical necessity and the specific regions treated. The medical record should include:
- The spinal regions manipulated
- Findings demonstrating subluxation or joint dysfunction (e.g., pain, stiffness, misalignment)
- Treatment rationale and response
Chiropractic examination notes - Objective measures before and after treatment
- Plan of care and follow-up recommendations
Medicare and many commercial payers require evidence of either:
- X-ray confirmation, or
- Physical exam evidence of subluxation
Detailed and clear notes help reduce denials and support ongoing care.
Billing Examples Using CPT 98940
Below is a simplified table to illustrate when the CPT code 98940 applies.
| Example | Scenario | Spinal Regions Treated | Correct Billing Code |
| Example 1: Localized Neck Pain | Patient receives adjustment for cervical dysfunction only. | Cervical = 1 region | 98940 |
| Example 2: Cervical & Thoracic Treatment | Chiropractor adjusts the cervical and thoracic regions. | Cervical + thoracic = 2 regions | 98940 |
| Example 3: Lower Back + Pelvic Pain (More Than 2 Regions) | Chiropractor treats lumbar, sacral, and pelvic regions. | Lumbar + sacral + pelvic = 3 regions | Use 98941 (not 98940) |
These examples show how accurate region counting ensures correct billing and prevents both undercoding and overcoding.
CPT Code 98940 vs. 98941: What’s the Difference?
These two chiropractic manipulation codes are often confused, leading to billing errors and reimbursement errors. While both codes apply to spinal manipulation, the distinction lies in the number of regions treated during the visit.
CPT Code 98940
CPT 98940 is used when chiropractic manipulation is performed on one or two spinal regions. This code is typically used during more focused visits, such as isolated cervical adjustments or treatment of localized lumbar pain. Because it reflects limited involvement, it represents a lower level of service compared to broader multi-region treatment.
CPT Code 98941
CPT 98941 is used when manipulation is performed on three to four spinal regions. This code is appropriate when the patient presents with broader dysfunction involving multiple interconnected regions. It indicates a more extensive level of chiropractic involvement and typically results in higher reimbursement.
Source: Pexels
How to Choose the Correct Code
The correct code depends entirely on how many spinal regions were treated—not on time spent or severity of pain.
- If one or two regions are treated, use 98940.
- If three or four regions are treated, use 98941.
Accurate region classification ensures both compliance and appropriate payment.
Common Billing Errors With CPT 98940
Even experienced chiropractic billers can make mistakes when reporting spinal manipulation services. Here are the most frequent errors associated with CPT 98940:
Incorrectly Counting Spinal Regions
Using the wrong number of regions leads to underbilling or incorrect coding. Chiropractors often overlook pelvic or sacral adjustments when counting regions, resulting in inaccurate claims.
Using CPT 98940 When More Than Two Regions Were Treated
Some claims are denied because documentation shows treatment in three or more regions, but the provider billed 98940. This undercoding reduces reimbursement and triggers payer audits.
Insufficient Documentation of Subluxation or Dysfunction
Claims require documentation showing the reason for treatment, including exam findings and clinical necessity. When this is missing or incomplete, payers often deny the service.
Not Meeting Payer-Specific Requirements
Some insurers require X-ray documentation, while others accept physical exam findings alone. Failing to meet these requirements leads to avoidable denials.
Confusing Spinal Regions With Non-Spinal Areas
98940 applies only to spinal manipulation, not extremity adjustments. Misclassifying non-spinal treatment as spinal manipulation leads to coding errors and compliance issues.
Conclusion
CPT Code 98940 plays a central role in chiropractic billing, ensuring proper reimbursement for spinal manipulative treatment involving one or two regions. Understanding when to use the code, how to count spinal regions accurately, and how to document findings clearly can significantly improve billing accuracy and reduce payer denials.
With proper coding knowledge and consistent workflow processes, chiropractic practices can streamline their billing, support compliance, and maintain optimal financial performance.
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