98943: Chiropractic manipulative treatment, extraspinal
Category: Extraspinal CMT
By Dr. Daniel Turner, DC · Reviewed September 2, 2026
What is 98943 used for?
The extraspinal adjustment code, covering chiropractic manipulative treatment of regions outside the spine: head, upper and lower extremities, rib cage, and abdomen.
How it works in a chiropractic practice
The code for the shoulder, wrist, knee, ankle, and TMJ work many chiropractors do alongside spinal care. It can be billed with a spinal CMT code on the same visit when both were performed and documented. Commercial coverage varies widely; some plans cover it like spinal CMT, others exclude extraspinal work entirely.
What the note must show
- ✓The extraspinal region treated and its findings
- ✓A diagnosis supporting the extremity or other extraspinal region on the claim, pointed from this line
- ✓Distinct documentation from the spinal CMT when both are billed together
A worked example
A runner with a documented lumbar complaint also has a restricted ankle treated the same visit. 98941 would overstate the spine work; the honest claim is 98940 for the lumbar and sacral findings plus 98943 for the ankle, each pointed at its own diagnosis. Point the ankle line at the lumbar diagnosis instead and the extraspinal line denies for diagnosis mismatch.
What the authorities say
Medicare limits chiropractor payment to manual manipulation of the spine to correct a subluxation, per the Benefit Policy Manual, Chapter 15, section 240. Extraspinal manipulation is outside the benefit entirely, which is a statutory wall rather than a documentation problem.
Billing 98943 with other codes on the same visit
- ✓Billable same day with any spinal CMT code when both are documented; it is not counted as one of the five spinal regions
- ✓Point it at an extremity or other extraspinal diagnosis; pointing it at the spinal diagnosis is the classic self inflicted CO-11
- ✓Some payers cap or exclude extraspinal CMT entirely, so the pairing that works at one payer may deny at the next
Does Medicare pay chiropractors for 98943?
Not covered. Medicare pays chiropractors for spinal manipulation only, so 98943 is excluded by statute regardless of documentation. With proper patient notice it is billable to the patient at the practice rate.
Where practices get burned
Pointing the extraspinal line at a spinal diagnosis; assuming commercial coverage without checking the plan; billing it to Medicare expecting payment.
How Cervica helps with 98943
Cervica's claim scrubber validates modifiers, units, and diagnosis pointers for 98943 before submission, per payer rules handle code substitutions and modifier requirements automatically, and when a payer pushes back anyway the denial worklist reads the adjustment codes and routes the claim to the exact fix.
Related codes
- →98940 · Chiropractic manipulative treatment, spinal, one to two regions
- →98941 · Chiropractic manipulative treatment, spinal, three to four regions
- →PR-170 / CO-170 · the denial this code most often triggers
- →CO-11 · the denial this code most often triggers
- →PR-96 · the denial this code most often triggers
Quick answers
What is 98943 used for?
The extraspinal adjustment code, covering chiropractic manipulative treatment of regions outside the spine: head, upper and lower extremities, rib cage, and abdomen.
What documentation does 98943 require?
The extraspinal region treated and its findings A diagnosis supporting the extremity or other extraspinal region on the claim, pointed from this line Distinct documentation from the spinal CMT when both are billed together
Does Medicare pay chiropractors for 98943?
Not covered. Medicare pays chiropractors for spinal manipulation only, so 98943 is excluded by statute regardless of documentation. With proper patient notice it is billable to the patient at the practice rate.
General information for billing teams, not legal, coding, or payer specific advice. CPT is a registered trademark of the American Medical Association; code descriptions here are paraphrased in our own words and the AMA's CPT publications control. Payer policies vary and control for any individual claim.