Chiropractic
Chiropractic Treatments
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TERMS
To help you better understand some of the terminology associated with Chiropractic, we have listed below definitions provided by the American Chiropractic Association. This is only a guide and not a diagnosis tool. If you have any questions, please ask a Dunwoody Wellness Center professional or contact your insurance company.
(Inclusion in this listing does not imply endorsement by the ACA for terms that refer to certain types of treatment. Technique definitions are courtesy of the 2005 NBCE Job Analysis of Chiropractic)
Abuse – Payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment
Activator Adjusting Instrument A handheld, spring activated, mechanical chiropractic adjusting instrument that delivers a controlled thrust.
Activator Technique – A system of adjustment using an Activator adjusting instrument.
Active Care Modes of treatment/care requiring involvement and participation on the part of the patient (e.g., exercises, wobble/balance boards).
Activities of Daily Living (ADLs) – Daily habits such as bathing, dressing, and eating. ADLs are often used as an assessment tool to determine an individual’s ability to function at home or in a less restricted environment of care. Can be used as a measurement of progress.
Accreditation – Process by which an organization recognizes a program of study or an institution as meeting predetermined standards.
Acupressure – Manual pressure applied to specific acupuncture points with the intention of stimulating neurological flow to various organs, glands or tissues, with the purpose of returning the body to a normal status.
Acupuncture – The art and science of using needles, and electrical/or manual stimulation of reflex centers throughout the body to create change within organs, glands, and tissues with intent to return the body to normal function.
Acute Condition – Conditions are considered “acute” within the first 48 weeks postinjury/illness.
Adjustment or Manipulation (Spine and Extremity) – Properly applied pressure to the skeletal system to modify joint integrity to produce a positive outcome. This can be done by the practitioner’s hand(s) (typically) or a handheld instrument.
Aggravation – Worsening of a preexisting medical condition or impairment in such a way that the degree of permanent impairment is increased.
Applied Kinesiology – A system of muscle testing used to augment traditional examination procedures.
Apportionment – Distribution or allocation of causation among multiple factors that caused or significantly contributed to the injury or disease and existing impairment.
Care Management – Coordination of the patient’s care by the practitioner including condition diagnosis, recommended treatment(s), referral to other practitioner(s), and patient self care (when appropriate).
Case Management – Method designed to monitor and coordinate specific health services of an insured to achieve the desired health outcome in a cost effective manner.
Cavitation – Formation of a cavity of gas in the liquid joint capsule which is forced out during manipulation of the joint and sometimes causing an audible release.
Chiropractic Assistant (CA) – An associate that assists the doctor of chiropractic with various office functions ranging from clerical to therapeutic. Some states require certification of chiropractic assistants in order for them to assist the doctor with therapeutic procedures. (CA/R refers to a Registered Chiropractic Assistant and CCA refers to a Certified Chiropractic Assistant)
Chronic Condition – Conditions are considered ‘chronic’ after the first 1216 weeks postinjury/illness.
Clinical Documentation – Recording of patient health information and health care services delivered by a provider to a patient in an acceptable format that allows for future reference by the provider, other providers, or external entities.
Cold/Hot Packs (Use of) – Cold or heat applied to a body region to relieve pain and swelling, and reduce muscle spasm.
Complication – Unexpected aggravation of an existing disorder or the onset of an unexpected new disorder as the result of treatment.
Congenital Condition – Exists at or dates from birth and may be acquired during development in the uterus (not hereditary).
Cox Flexion/Distraction – A system of procedures using distraction, or doctor controlled tractive forces applied to a specific level of the spine with or without articular facet adjustment.
Cranial Technique – A technique to correct immobilities and asymmetries of the cranial bones.
Date of Service (DOS) – The date a health care service was rendered by the provider to the patient.
Diagnosis – A description of a patient’s clinical condition most commonly represented by accepted ICD9 codes (International Classification of Diseases, 9th version).
Disability – Physical or other limitation of an individual’s capacity to meet personal, social or occupational demands. A substantial limitation that interferes with performing major life activities.
Diversified Technique [or FullSpine Specific (FSS)] – A full spine chiropractic adjustive technique designed to correct vertebral subluxations in the most efficacious manner possible with respect to the clinical circumstances. Typically each chiropractic college teaches its own chiropractic technique.
Decompression Reduction Stabilization (DRS) – See Spinal Decompression
Electrical Stimulation – Electrical impulses applied through the skin using pads that conduct the impulses to the muscles and nerves for the purpose of increasing circulation, decreasing pain and muscle spasm, and facilitating healing of injured soft tissues.
Established Patient – A patient who has received professional services from the physician, or another physician of the same specialty belonging to the same group practice, within the past three years. (For Evaluation and Management services [E/M], the appropriate CPT codes include 99211 through 99215)
Exacerbation – An increase in the severity of a condition(s) or the patient’s symptoms.
Extremity Manipulation/Adjustment – The application of chiropractic manipulation/adjustment to joints other than those of the spine, i.e., shoulder, elbow, wrist/hand/finger, hip, knee, ankle/foot/toe. Examples of conditions treated by extremity manipulation/ adjustment: carpal tunnel syndrome, gait, or posturerelated problems.
Fee For Service (FFS) – Specific payment amounts for specific services rendered/received determined by insurers.
Fee Schedule – List of established fees, or maximum amounts allowed, for specified health services.
Fraud – Knowingly or wantonly misleading or misrepresenting patient treatment circumstances or any other dynamic of the healthcare industry, resulting in any type of financial gain for the doctor, patient, or any third party or entity.
Functional Limitation – Classification applied due to a patient’s inability to adequately perform a task due to impairment.
Global Fee – A flat fee paid per date of service that encompasses all services provided.
Gonstead – Technique A full spine chiropractic method developed by Clareence Gonstead, D.C. that utilizes radiographic analysis, instrumentation, and palpation to locate and specifically determine the malposition of subluxated vertebrae, which are then corrected manually.
Hypotonicity – The state of a muscle that has lost tone and strength due to a medical condition, resulting in weakness. For example, a disc problem in the spine may allow the muscles in the leg or arm to become weak or hypotonic, in essence losing tone and strength.
Hypertonicity – The state of a muscle in which the muscle fibers contract, resulting in a spastic or “tight” muscle.
Intervertebral Disc Decompression (IDD) – See Spinal Decompression
Imaging – Studies that may include xrays and/or other advanced diagnostic procedures such as magnetic resonance imaging (MRI) or computerized tomography (CT) scan, to aid in the diagnosis of a patient’s condition.
Impairment – Complete or partial loss of use due to a medical condition of any psychological, physiological or anatomical body function.
Logan Basic Technique – An adjustive technique developed by Hugh B. Logan, D.C. that utilizes an integrated system of body mechanics and adjusting procedures.
Low Level Laser Therapy (Cold Laser) – This treatment refers to a wide variety of procedures involving several laser types and treatment methods using devices that typically emit laser beam wavelengths between 600 and 1000 nanometers. LLLT is a proposed treatment for various medical conditions and is believed to promote healing of injured tissues.
Manipulation/Adjustment – Cross Reference: “Adjustment or Manipulation”
Manipulation Under Anesthesia (MUA) – A noninvasive procedure for the treatment of both acute and chronic conditions including neck pain, lower back pain, fibrous adhesions, long term pain disorders, etc. The procedure may involve varying degrees of anesthetization from local to complete, during which the doctor manipulates the affected joints. The advantage to MUA is complete muscle laxity and removal of guarding or protective instincts that inhibit normal manipulation procedures. This procedure is normally performed by DCs, MDs, and DOs.
Manipulative/Adjustive Instruments – A device that delivers a controlled therapeutic thrust.
Manual Therapy – A procedure by which the hands directly contact the body to treat articulations and/or soft tissues to achieve a greater degree of mobility or to reduce pain.
Massage – Repetitive pressure and kneading motions applied to a body region(s) to break down inflammation and muscle spasm. Types of massage include effleurage, petrissage and tapotement.
Maximum Medical Improvement (MMI) – A condition or state that is well stabilized and unlikely to change within the next year, with or without treatment.
Maximum Therapeutic Benefit (MTB) – A status after treatment where a patient has either returned to preinjury/illness or failed to improve beyond a certain level of symptomatology or disability, whatever the condition or treatment/care approach.
Medical Necessity – A term used to describe a patient’s clinical need for health care services and supplies that are appropriate for evaluation and treatment of a disease, condition, illness, or injury.
Meric System – A system of analysis and adjusting in which the body is divided into zones corresponding to vertebral levels.
Mobilization – Movement applied singularly or repetitively within or at the physiological range of joint motion, without imparting a thrust or impulse, with the goal of restoring joint mobility.
Modalities – A physical agent applied to produce therapeutic changes to biologic tissues and includes, but is not limited to thermal, acoustic, light, mechanical or electrical energy. Modalities are performed either as supervised (nonattended) or constant attendance (requiring 11 direct contact with the patient). Attended Therapies are often not performed by the doctor, but are delegated to staff members. The legal ability to delegate treatment varies based on state law.
National Provider Data Bank (NPDB) – Computerized data bank maintained by the federal government that compiles information on providers against whom malpractice claims have been made or disciplinary actions have been taken.
New Patient – A patient who has not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.
Nimmo/ Receptor Tonus TechniqueA system of deep connective tissue and myofascial manipulation developed by Raymond Nimmo, D.C.
Palliative Care – Treatment provided by the practitioner to ease the pain and discomfort of a condition, without correcting the condition.
Palmer Upper Cervical/HIO Technique – A technique that utilizes specific radiographic analysis and adjusting procedures developed by B.J. Palmer, D.C. for correction of upper cervical vertebrae only.
Passive Care – Application of treatment/care modalities by the practitioner to a patient where the patient involvement or participation is not required (e.g., manipulation, massage, and some physical medicine and rehabilitation modalities).
Peer Review – Evaluation of health care services, by healthcare personnel of similar training, to evaluate quality and appropriateness of care (e.g. necessity, frequency, efficacy) provided.
Peer Review Organization (PRO) – Organizations that review medical records and claims to evaluate quality and appropriateness (e.g. necessity, frequency, efficacy) of care provided.
Permanent Impairment – Complete or partial loss of use due to a medical condition of any psychological, physiological or anatomical body and is not likely to improve with further medical treatment.
Physical Medicine and Rehabilitation – Rehabilitation concerned with restoration of function and prevention of disability following disease, injury, or loss of body part. The therapeutic properties of exercise, heat, cold, electricity, ultraviolet radiation, and massage are used to improve circulation, strengthen muscles, encourage return of motion, and train or retrain an individual to perform the activities of daily living.
Pierce/Stillwagon Technique – A fullspine technique that utilizes specific radiographic analysis, instrumentation, and adjusting procedures developed by Walter Pierce, D.C. and Glenn Stilllwagon, D. C.
Preexisting Condition – Condition developed prior to issuance of a health insurance policy that may result in the limitation of coverage or benefits.
Preventive Care – Treatment that is not provided in response to a specific injury or illness but is intended to hinder the occurrence of disease, prolong life, promote health and enhance the quality of life.
Sacro Occipital Technique/ S.O.T. – A system of soft tissue, reflex, diagnostic, and adjusting techniques developed by M.B. DeJarnette, D.C.; this technique emphasizes the close physiological and biomechanical relationships between the pelvis and the cranium.
Sacrum – The triangular bone situated between the crests of the ilia (pelvic bones) (horizontally) and the fifth lumbar vertebra and the coccyx (vertically). Consists of five fused vertebra. The articulations with the ilia (pelvic bones) create the sacroiliac joints.
Spinal Regions – There are five regions which include: 1) Cervical – the atlantooccipital joint (between the baseof the skull and the first cervical vertebra) and C1 through C7; 2) Thoracic T1 through T12; 3) Lumbar L1 through L5; 4) Sacral the sacrum, including the sacrococcygeal junction; 5) Pelvic the sacroiliac joints and other pelvic articulations.
Spinal Decompression – A nonsurgical treatment for herniated discs that uses a specialized table to decompress one or more spinal discs, creating negative pressure within the disc space(s) and allowing the rehydration of the discs themselves and restoration of the disc to a normal state. Examples include VAXD, DRX9000, DRS, AccuSpina, IDD Therapy and DTS tables.
Subacute Condition – A term referring to conditions that are between the acute and chronic phases (usually occurs somewhere within 516 weeks postinjury/illness).
Subluxation Complex/Syndrome – A theoretic model of motion segment dysfunction (subluxation) that incorporates the complex interaction of pathologic changes in nerve, muscle, ligamentous, vascular, and connective tissues.
Symptom Magnification – Conscious and willful feigning or exaggeration of the effect of an injury or symptoms of a disease process in order to obtain external gain.
Thompson Technique – A system of analytical and adjusting techniques developed by J. Clay Thompson, D.C. that emphasizes the use of a Thompson terminal point adjusting table.
Traction Devices – The therapeutic use of mechanical tension created by a pulling force to produce a combination of distraction and gliding to relieve pain and increase tissue flexibility.
Trigger Point – A focal spot of tenderness within a muscle that may cause local or referred pain.
Ultrasound (Therapeutic) – High frequency sound waves transmitted subcutaneously to produce pulsing or heating of body tissues to promote healing.
Ultrasound (Diagnostic) – The use of ultrasound to image soft tissues. This procedure is viewed as providing no useful clinical information when used to evaluate for neck and back pain. There are current studies that indicate it may be a valuable tool for extremity tissue evaluation.
Wellness Care – An active care model where patients play a role in achieving their best possible health. Patient instruction emphasizes wellness, health promotion, and disease prevention.
Whiplash – Associated Disorders A syndrome (including multiple symptoms or conditions) often caused by a sudden violent force placed on the neck (cervical spine).
