74 - Are You Misusing the AT Modifier?

Hosts Paul Andrews and Dr. Mark Davini break down why the AT modifier on chiropractic manipulation (CMT) claims matters and how Medicare defines active, chronic and maintenance subluxations. They explain the difference between acute and active treatment, when AT is appropriate, and why pain alone does not justify ongoing AT billing.

The episode covers practical topics: use of outcome assessment tools to document functional improvement every 30 days, proper use of the GA modifier and ABN, pitfalls of generic documentation, and the audit/extrapolation risk when claims are billed incorrectly. Listeners will learn billing best practices to avoid denials and recoupments and why understanding CMS definitions is critical to protecting your practice.