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A subluxation syndrome is the clinical signs and symptoms relating to
pathophysiology or dysfunction of spinal motion segments that may be amenable to manipulative /
adjustive procedures. This entails an aberration of normal spinal biomechanics, usually involving a
restriction or loss of a motion segment, and associated aberrations in the tissues that support
articular motion. This clinical condition can be assessed by careful motion palpation documenting
loss of joint play or end range of motion, and may also be evidenced via subtle biomechanical changes
in diagnostic imaging. For Medicare purposes, a chiropractic provider, or a radiologist should
determine substantiation of a subluxation for determination of a manipulable lesion on diagnostic
imaging with training in chiropractic manipulative treatment procedures.
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