indicator of where to start and then orthopedic testing, neurological testing, testing reflexes. Dr. Hoffman: What about the parent that wants to bring their children in just because they get it? They understand the chiropractic lifestyle and what it means for them over the course of their lifetime and their children's lifetime. Is there any difference in your approach to those children that may not even have any symptoms to address? Dr. Apfelblat: They're still going to fill out the same form. What I love about these families is that they understand wellness. Most likely, they're environment at home is a more healthy, more stress-free environment. They probably eat healthier. There are probably less stress to manage at home. We would still perform the same examination. We would still give them the same health intake form. We would still check them for subluxation. Even just normal milestones, learning to crawl, learning to walk, learning to ride a bicycle are all very important times to be checked just for wellness in general. If you're a wellness patient, perhaps you won't need to be checked as much as someone who has an injury. It's always important to check children on a regular basis. Dr. Hoffman: Agreed. Let's talk a little bit about the actual documentation and maybe even how you diagnose. How do you go about your documentation procedures with these families that come in? Dr. Apfelblat: I use chiropractic ... I use chiropractic diagnostic codes and muscular skeletal codes. Again, in the report of finding is when you're going to explain to the parent where the vertebral subluxation is in the spine. You're explaining to them the code you're actually using. I've never had a problem with codes for diagnosing for children except early on in practice. It wasn't so much a coding as my notes. Early on my practice, I had some rejections from an insurance company, a commercial insurance company. I appealed those claims. A staff member, a chiropractor from the insurance company had a meeting with me over the phone. I explained to him that I was treating vertebral subluxation. He said, "Yes, but in your notes it says, 'This child has a cold. He has a fever. He is irritable.' We don't treat colds. As a chiropractor, you can't treat a cold. You can't treat a fever. You can't treat irritability." I said, "Yes. My objective findings [substantiate 00:22:19] vertebral subluxation." He said that it's really important, and I've done this since then, and I have not had an issue since that time, so I feel very fortunate to have this conversation, is I will put my subjective chiropractic, the
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