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Advisory 96-17


The Commission provides the following information to clarify Rule 134.600(h)(10).

For the purposes of preauthorization under Rule 134.600, manipulations are not considered a part of physical therapy or occupational therapy. This includes all manipulations to the hand or wrist; all cervical, thoracic, lumbosacral, and sacroiliac manipulations; and all osteopathic manipulative treatment. Therefore, even after eight weeks of physical or occupational therapy, therapeutic or osteopathic manipulations do NOT require preauthorization. The Commission has historically applied Rule 134.600(h)(10) in this manner.

Insurance carriers shall not deny payment for therapeutic or osteopathic manipulations due to preauthorization not being obtained. As with all treatments and services not specifically addressed in the Commission's preauthorization rule, these treatments are subject to retrospective review for reasonableness and medical necessity.

Signed November 15, 1996

Todd K. Brown, Executive Director