| (a) Definitions. The following words and terms, when
used in this chapter, shall have the following meanings, unless the
context clearly indicates otherwise:
(1) Board--The Texas Board of Chiropractic Examiners.
(2) CPT Codebook--The American Medical Association's
annual Current Procedural Terminology Codebook (2004). The CPT Codebook
has been adopted by the Centers for Medicare and Medicaid Services
of the United States Department of Health and Human Services as Level
I of the common procedure coding system.
(3) Cosmetic treatment--A treatment that is primarily
intended by the licensee to address the outward appearance of a patient.
(4) Incision--A cut or a surgical wound; also, a
division of the soft parts made with a knife or hot laser.
(5) Musculoskeletal system--The system of muscles and
tendons and ligaments and bones and joints and associated tissues
and nerves that move the body and maintain its form.
(6) On-site--The presence of a licensed chiropractor
in the clinic, but not necessarily in the room, while a patient is
undergoing an examination or treatment procedure or service.
(7) Practice of chiropractic--The description and terms
set forth under Texas Occupations Code §201.002, relating to
the practice of chiropractic.
(8) Subluxation--A lesion or dysfunction in a joint
or motion segment in which alignment, movement integrity and/or
physiological function are altered, although contact between joint
surfaces remains intact. It is essentially a functional entity, which
may influence biomechanical and neural integrity.
(9) Subluxation complex--A neuromusculoskeletal condition
that involves an aberrant relationship between two adjacent articular
structures that may have functional or pathological sequelae, causing
an alteration in the biomechanical and/or neuro-physiological reflections
of these articular structures, their proximal structures, and/or other
body systems that may be directly or indirectly affected by them.
(b) Aspects of Practice.
(1) A person practices chiropractic if they:
(A) use objective or subjective means to analyze, examine,
or evaluate the biomechanical condition of the spine and musculoskeletal
system of the human body; or
(B) perform nonsurgical, nonincisive procedures, including
adjustment and manipulation, to improve the subluxation complex or
the biomechanics of the musculoskeletal system.
(2) Needles may be used in the practice of chiropractic
under standards set forth by the Board but may not be used for procedures
that are incisive or surgical.
(3) This section does not apply to:
(A) a health care professional licensed under another
statute of this state and acting within the scope of their license;
or
(B) any other activity not regulated by state or federal
law.
(c) Examination and Evaluation.
(1) In the practice of Chiropractic, licensees of this
board provide necessary examination and evaluation services to:
(A) Determine the bio-mechanical condition of the spine
and musculoskeletal system of the human body including, but not limited
to, the following:
(i) the health and integrity of the structures of the
system;
(ii) the coordination, balance, efficiency, strength,
conditioning and functional health and integrity of the system;
(iii) the existence of the structural pathology, functional
pathology or other abnormality of the system;
(iv) the nature, severity, complicating factors and
effects of said structural pathology, functional pathology or other
abnormality of the system;
(v) the etiology of said structural pathology, functional
pathology or other abnormality of the system; and
(vi) the effect of said structural pathology, functional
pathology or other abnormality of the system on the health of an individual
patient or population of patients;
(B) Determine the existence of subluxation complexes
of the spine and musculoskeletal system of the human body and to evaluate
their condition including, but not limited to:
(i) The nature, severity, complicating factors and
effects of said subluxation complexes;
(ii) the etiology of said subluxation complexes; and
(iii) The effect of said subluxation complexes on the
health of an individual patient or population of patients;
(C) Determine the treatment procedures that are indicated
in the therapeutic care of a patient or condition;
(D) Determine the treatment procedures that are contra-indicated
in the therapeutic care of a patient or condition; and
(E) Differentiate a patient or condition for which
chiropractic treatment is appropriate from a patient or condition
that is in need of care from a medical or other class of provider.
(2) To evaluate and examine individual patients or
patient populations, licensees of this board are authorized to use:
(A) physical examinations;
(B) diagnostic imaging;
(C) laboratory examination;
(D) electro-diagnostic testing, other than an incisive
procedure;
(E) sonography; and
(F) other forms of testing and measurement.
(3) Examination and evaluation services which require
a license holder to obtain additional training or certification, in
addition to the requirements of a basic chiropractic license, include:
(A) Performance of radiologic procedures, which are
authorized under the Texas Chiropractic Act, Texas Occupations Code,
Chapter 201, may be delegated to an assistant who meets the training
requirements set forth under §74.2 of this title (relating to
Registration of Chiropractic Radiologic Technologists).
(B) Technological Instrumented Vestibular-Ocular-Nystagmus
Testing may be performed by a licensee with a diplomate in chiropractic
neurology and that has successfully completed 150 hours of clinical
and didactic training in the technical and professional components
of the procedures as part of coursework in vestibular rehabilitation
including the successful completion of a written and performance examination
for vestibular specialty or certification. The professional component
of these procedures may not be delegated to a technician and must
be directly performed by a qualified licensee.
(d) Analysis, Diagnosis, and Other Opinions.
(1) In the practice of chiropractic, licensees may
render an analysis, diagnosis, or other opinion regarding the findings
of examinations and evaluations. Such opinions could include, but
are not limited to, the following:
(A) An analysis, diagnosis or other opinion regarding
the biomechanical condition of the spine or musculoskeletal system
including, but not limited to, the following:
(i) the health and integrity of the structures of the
system;
(ii) the coordination, balance, efficiency, strength,
conditioning and functional health and integrity of the system;
(iii) the existence of structural pathology, functional
pathology or other abnormality of the system;
(iv) the nature, severity, complicating factors and
effects of said structural pathology, functional pathology, or other
abnormality of the system;
(v) the etiology of said structural pathology, functional
pathology or other abnormality of the system; and
(vi) the effect of said structural pathology, functional
pathology or other abnormality of the system on the health of an individual
patient or population of patients;
(B) An analysis, diagnosis or other opinion regarding
a subluxation complex of the spine or musculoskeletal system including,
but not limited to, the following:
(i) the nature, severity, complicating factors and
effects of said subluxation complex;
(ii) the etiology of said subluxation complex; and
(iii) the effect of said subluxation complex on the
health of an individual patient or population of patients;
(C) An opinion regarding the treatment procedures that
are indicated in the therapeutic care of a patient or condition;
(D) An opinion regarding the likelihood of recovery
of a patient or condition under an indicated course of treatment;
(E) An opinion regarding the risks associated with
the treatment procedures that are indicated in the therapeutic care
of a patient or condition;
(F) An opinion regarding the risks associated with
not receiving the treatment procedures that are indicated in the therapeutic
care of a patient or condition;
Cont'd... |
