Current through Register Vol. 56, No. 18, September 16, 2024
(a) A
chiropractic physician performing or interpreting electrodiagnostic tests and
special examinations shall:
1. Adhere to
accepted standards of practice applicable to the performance of such tests
relating to clinical justification, reliability, validity, performance
technique, interpretation and integration into the plan of treatment;
2. Ensure that tests, if performed by a
chiropractic physician, are performed personally or under his or her immediate
personal supervision and direction;
3. Assure that professionally responsible and
scientifically sequential pre-testing determinations are followed;
4. Take and document, in the patient's
record, a relevant history of the complaints presented by the patient.
Chiropractic records shall meet acceptable clinical standards and contain such
pertinent information including height, weight, past medical and surgical
history and other information that may influence the outcome or interpretation
of the testing;
5. Perform, at a
minimum, a problem-focused examination;
6. Establish and document in the patient's
record, a provisional diagnosis with clinical correlation; and
7. Abide by appropriate standards of informed
consent explaining potential risks, potential benefits and other clinical
options.
(b) A
chiropractic physician requesting the performance of electrodiagnostic tests
and other special examinations with respect to a specific patient shall first:
1. Take and document in the patient record a
history of the patient's clinical condition, reflecting:
i. Responses to inquiries regarding prior
disease, trauma, surgery, prior and current medications prescribed by other
practitioners, use of orthopedic devices and other relevant information, as
applicable to the patient's situation;
ii. Factors which may be contributing to the
patient's pain, sensory or motor complaints; and
iii. Pertinent information such as the
patient's current height and weight, employment (including physical
requirements, whether in or outside the home) and relevant aspects of required
work effort, known injuries, testing performed and results, care received,
response and other factors which may be relevant to the patient's
condition;
2. Perform
and document in the patient record a clinical examination including subjective
complaints, observations, objective findings from a neurologically oriented
physical examination, tests performed and their results including x-ray
interpretation, interpretive reports of imaging studies acquired from any
source, and interpretive reports of any other testing;
3. Establish and document in the patient
record a provisional diagnosis and plan of care;
4. Prepare and document in the patient record
ongoing progress notes reflecting subjective complaints, objective findings,
treatment provided, and the patient's objective and subjective response to the
treatment provided; and
5. Discuss
with the patient appropriate alternatives and options, including referral to
another practitioner or specialist for consultation and evaluation.
(c) A chiropractic physician who
has complied with the requirements of (b)1 through 5 above may request
electrodiagnostic tests or special examinations if the results of tests
selected are expected to:
1. Alter the course
of the patient's treatment;
2. Aid
in determining the extent of functional deficit present; and
3. Be useful in the assessment of
deterioration or improvement of a condition for the purpose of continued
care.
(d) A chiropractic
physician who has complied with the requirements of (b)1 through 5 above may
refer a patient to another chiropractic physician or other appropriately
licensed and trained practitioner to determine the need for, and the
performance and interpretation of, an electrodiagnostic test or a special
examination by means of a request for professional consultation, provided the
referring chiropractic physician:
1.
Thoroughly documents in the patient record an appropriate scientific rationale
for the referral; and
2. Directly
communicates with the practitioner who is to perform the test, prior to the
referral, as is professionally appropriate in the circumstances.
