Notice of Processing issue with Chiropractic and Osteopathic Treatment Reimbursement Policy Coding Change

Effective June 15, 2026, Blue Cross Blue Shield of North Dakota (BCBSND) implemented changes to the Chiropractic and Osteopathic Treatment reimbursement policy.

These changes require:

• Placement of a subluxation diagnosis code in the primary diagnosis code field when billed with Chiropractic Manipulative Treatment (CMT) procedure codes 98940 – 98943. Claims submitted without the appropriate primary subluxation diagnosis code will be denied as not reimbursable.
• Use of modifier AT for Medicaid Expansion claims. Modifier AT must be appended to all CMT codes to indicate active or corrective treatment for acute or chronic subluxation. Claims submitted without this modifier will be denied as non-covered.

BCBSND identified a processing issue where CMT 98943 was denied incorrectly as the primary diagnosis on the line was a subluxation diagnosis code. This issue impacted claims processed from June 15 to June 25. BCBSND will be adjusting the incorrectly denied services. Providers do not need to submit an appeal for denied CMT 98943 when the primary diagnosis code on the line was subluxation.

Questions?
Contact the phone number on the back of the member’s ID card.