NYSBC opinion regarding Electrodiagnostic Testing.

Section 6551 of Education Law defines the practice of chiropractic as "detecting and correcting by manual or mechanical means structural imbalance, distortion, or subluxations in the human body for the purpose of removing nerve interference and the effects thereof, where such interference is the result of or related to distortion, misalignment or subluxation of or in the vertebral column."

The use of electrical devices by chiropractors is restricted to the above definition of practice, and, pursuant to section 73.3 of the Regulations of the Commissioner of Education, to those devices deemed appropriate to the practice of chiropractic by the Department and which have not been disapproved by the Federal Food and Drug Administration.

Consequently, chiropractors licensed in this State may conduct or order and interpret electrodiagnostic testing appropriate to the practice of chiropractic, which includes but is not limited to Doppler ultrasound, somatosensory evoked potentials (SSEP), nerve conduction velocity (NCV) studies, electroencephalography (EEG), magnetic resonance imaging (MRI), surface and needle electromyography (EMG), and auditory brainstem testing. Such testing may be conducted for the purpose of diagnosing "nerve interference and the effects thereof" resulting from or related to "distortion, misalignment or subluxation of or in the vertebral column."

Also, please note that the Board of Regents Rules on Unprofessional Conduct holds that a practitioner may be in violation of Part 29.1(b)(9) if he or she is "performing professional responsibilities which the licensee knows or has reason to know that he or she is not competent to perform." It is clearly the responsibility of the licensee to acquire appropriate education and training prior to provision of any professional service. Special certification in the use of any professional practice is not required prior to utilization, but certainly would provide evidence of competency in any event.

Utilization of any test or treatment modality is addressed in Regents Rules on Unprofessional Conduct, Part 29.2(a)(7), which includes as a defined violation the "ordering of excessive tests, treatment, or use of treatment facilities not warranted by the condition of the patient".

Insurance coverage for any procedure performed by licensed professionals is not determined by Education Law. Although this department may determine that a specific procedure is within the lawful scope of a given profession, that by itself does not constitute a requirement for reimbursing the cost of such a procedure under insurance benefit plans. Lawful scope of professional practice and insurance coverage are separate and distinct determinations made in accordance with Education Law and Insurance Law respectively.

Finally, it has been determined that so long as an individual is trained to administer a non-invasive electrodiagnostic test, there is nothing improper about having that individual mechanically administer such tests and record their results. Such activity is simply the operation of machinery and collection of data without any treatment, assessment of patient condition, or professional judgment or expertise being used. Thus, such activity is considered to be technician's work and not the practice of medicine, chiropractic or any other profession.

Norman G. Cohen
Executive Secretary

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