Chiropractic Record Attachment (CHIRO)

Supports chiropractic medical necessity with exam findings, plan, and progress notes.

 

 

 

Data Field Information
Prompt Response Req Len
Date of Initial Treatment Enter the date you want or click the calendar icon to select a date. 10
Date of Last X-Ray Enter the date you want or click the calendar icon to select a date.   10
# in Series Enter the number in the series.   50
Level of Subluxation Enter the level of subluxation.   50
Treatment Months/Yrs Enter the number of treatment months/years.   50
Number of Treatment/Mos Enter the number of the treatment/months.   50
Nature of Condition Select the condition you want from the list. 1
Date of Acute Manifestation Enter the date you want or click the calendar icon to select a date.   10
Complication Indicator Select the indicator you want from the list.   1
Symptoms Enter the patient's symptoms.   50
X-Rays on File If there are x-rays on file for the patient, select this check box.   1
Patient Condition Line 1 and Line 2 Enter the patient condition.   50