Medical Necessity for X-Ray Digitization

Medical Necessity for X-ray Digitization

X-ray digitization and analysis is necessary when a patient’s history and subjective complaints indicate possible musculoskeletal involvement and spinal x-rays are taken to evaluate biomechanical stability. Chiropractic scope of practice laws vary from state to state; by the Chiropractic profession’s clinical education and practice guidelines; as well as legal precedent. (Willet v Rowekamp, 1938)

The “Osseous Component” of the vertebral subluxation complex (VSC) can only be objectively identified and documented via x-ray imaging and analysis. It is the clinician’s responsibility to detect the osseous component of the vertebral subluxation complex for the following reasons:

·  Diagnose the presence, or absence, of spinal subluxation (VSC).

·  Quantify the osseous component of the subluxation complex (VSC).

·  Correlate symptomatology related to trauma with biomechanical changes.

·  Plan an appropriate treatment protocol.

·  Provide documentation of a patient’s biomechanical issues.

A follow-up comparative study is performed after 6-8 weeks of care to:

·  To re-evaluate the patient’s injury and response to treatment.

·  To determine need for additional care or establish maximum improvement.

·  To score their level of impairment based upon ligamentous injury.

Digital analysis using computerized technology is preferred as there is a significant error rate for hand Mensuration. [Up to 26%. Sigler & Howe, Inter & Intra examiner reliability of the upper cervical marking system. JMPT 1985 8:75-80.]

Legal precedent requires Physicians to use the best factual data available. The Pennsylvania Supreme Court (Smith vs. Yohe, 1963) ruled that a treating doctor was negligent for not using the best factual data upon which to arrive at his diagnosis.

Computer-Aided Digital Radiographic Analysis provides the only precise and objective analysis of the biomechanical improprieties of the spine in order to diagnose a Subluxation, delineate an objective treatment plan and make comparisons at follow-up.

Patient Name: ______

Treating Doctor: ______Date:______