Recently, my recommendations have been more conservative. Instead of describing the multiple areas of subluxation, I have urged offices to describe only the primary subluxation level and the associated conditions. If you list the primary level only and the patient sustains an injury or trauma to a different level at a later time, you have justification for changing the primary level as the result of the accident. Because of the accident, additional care will be required. If the level of injury had been listed among the original list of levels of subluxation, the resulting care could be considered related to a pre-existing condition and rejected.
Insurance companies seem to be targeting exhaustive diagnoses for review.
Since Medicare forced doctors and hospitals to justify the need for hospitalization based on a few restricted diagnostic categories, doctors have tried to accommodate the needs of a Medicare patient for increased coverage based on diagnosis. This has resulted in unusually lengthy diagnostic descriptions. It seems that the end result has been to cast suspicion on extensive diagnoses. Part of the rationale that they seem to be using is a penalty for completeness. When determining the number of visits allowed, they seem to be deducting for extra diagnoses rather than realizing that a more complicated condition takes a longer time to heal.