Five identical visits to the chiropractor

Billed in different combinations, processed for varying amounts.

7/25
98942: $40
97012: $0

7/3
98942: $40
97110: $0

6/28
98940: $32
97110: $15

6/13
98942: $40
97110: $15

5/9
98942: $40
97012: $10

So 98942 (adjustment of 5 or more regions) is worth $40, and 98940 (adjustment of 1-2 regions) is worth $32. 97012 is worth $0 or $10 at random. 97110 is worth $0 or $15 at random. For any given trip to the chiropractor, there’s no way to tell whether I’ll be billed for a 98942 adjustment or 98940 adjustment. The billing could theoretically turn up as 98941 and just hasn’t recently. There’s no way to tell whether I’ll be billed for 97012 (mechanical traction) or 97110 (therapeutic exercise). Neither seems related to reality, but one of them is always billed. The total could be $32, $40, $42, $47, $50, or $55, all for the same basic visit to the chiropractor with the same adjustment done.

Since I’m within my deductible, I actually pay all charges after the insurance company rolls the dice. This isn’t just an exercise in theory. 20 visits a year should total $640, but can actually total up to $1100. That’s a bit of a difference over time, and makes it difficult to plan for.

It’s a relief to have this figured out even this much, because it had been a black box for ages while the billing codes were entirely hidden.