The American Chiropractic Association (ACA) has announced that it has been working with the American Medical Association (AMA) to introduce four new CPT codes which would permanently label chiropractic care as "Chiropractic Manipulative Therapy" (CMT).

Boasting of its victory in its own magazine, as well as on its Internet home page, the ACA stated: "After many years of persistent efforts by the American Chiropractic Association, doctors of chiropractic will now be able to use four chiropractic-specific manipulation codes (Chiropractic Manipulative Treatment, or CMT, codes), which are included in the AMA's CPT-'97. These codes replace A2000, which has been used for many years as a catch-all code for chiropractic spinal manipulative treatment [emphasis added] under Medicare."

Since the home page may be accessed by millions of Internet users, the ACA went on to "define" CMT: "Chiropractic manipulative treatment (CMT) is a form of manual treatment to influence joint and neurophysiological function. This treatment may be accomplished using a variety of techniques."

Nowhere in the Internet information does the ACA use the term subluxation or adjustment. Nor does it reveal the fact that the inclusion of the codes was not agreed upon or sanctioned by the profession as a whole.

Terry Rondberg, D.C., president of the World Chiropractic Alliance and publisher of The Chiropractic Journal, said that the use of CMT codes was unacceptable because they do not recognize the essential distinction between chiropractic and medical spinal manipulation as performed by osteopaths and medical doctors.

"The real tragedy," he noted, "is that -- once again -- the ACA has betrayed the profession by acting unilaterally on a matter which involves all chiropractors. It is irresponsible for the ACA to continue making decisions for the entire profession when less than half of all D.C.s even belong to the group, whose numbers by all reports are dwindling rapidly."

He added that it was also irresponsible of the American Medical Association to negotiate with only one small segment of the profession on an issue as important as CPT codes.

"I'm sure the AMA was well aware that it would not have been able to lump chiropractic in with medical manipulation if negotiations had been carried out involving organizations like the ICA or the WCA. AMA leaders turned to the only group willing to do their bidding."

It is ironic the announcement came at the same time that the Association of Chiropractic Colleges issued its position statement on chiropractic -- which discusses chiropractic philosophy, subluxation, and the human body's innate healing ability. (For more details on the ACC paper, see "From the publisher," on page 10.)

Apparently, just as the presidents of all North American colleges are reaffirming their dedication to maintaining chiropractic as a unique, subluxation-based health care system, the ACA is continuing its efforts to follow the lead of osteopaths and turn chiropractic into a medical therapy.

"This newspaper has long reported how out of touch the ACA is with its membership and chiropractic in general, and how unconcerned it's been to represent the profession honestly," stated Rondberg. "Going off by itself down such a dangerous road now provides more clear evidence as to how far from the mainstream of chiropractic thought the ACA has wandered."

Response from other doctors of chiropractic was immediate and angry.

"Have you been fighting for chiropractic all this time to have been sold out to the medics?," asked Robert Braile, D.C., president of the International Chiropractors Association (ICA) in an open letter to D.C.s around the country. "Well, it appears that's what's happened! The ACA has struck a deal with the AMA and gotten codes for the entire profession. The only problem is that these codes ... are not for chiropractic adjustments, but rather for 'Chiropractic Manipulative Therapy!' This is not what I do in my office!"

Many doctors learned of the ACA-AMA deal only after receiving ACA marketing material which advertised a series of coding seminars which began last month.

"It is obvious from the scheduling that the ACA knew some time ago that this code change was a done deal," said Dr. Rondberg. "As happened in the case of the Mercy Conference Guidelines, action was taken without the approval of the profession, and now ACA leaders are proceeding to stuff these codes down our throats."

In the seminar brochure, the ACA boasts about its part in the development of the manipulation codes: "Nobody knows the new chiropractic manipulation codes like the ACA. We helped draft them and we know how D.C.s can best use the new system to expand their opportunities. Remember, starting next year, chiropractors will be required by most third-party payors to use the new codes in the private sector and inclusion in Medicare is also likely." (Emphasis added.)

A sales letter accompanying the brochure urges, "Don't go anywhere else for this vital information. Only the ACA can offer you the in-depth, insider's view you need..."

After reading the sales pitch, Rondberg urged doctors not to be lured to the seminars by the obvious scare tactics.

"I am not surprised that the ACA would turn this entire matter into a lucrative source of revenue. I'm merely shocked and appalled that it's being done so blatantly," he stated.