Adjunctive Procedures Certification and Scope of Practice
Domain 3 tests the boundary between the core chiropractic license and additional certification for adjunctive procedures, plus supervision, delegation, documentation, and billing within scope.
Core scope
The Act defines chiropractic practice; it is not a general medical license. Core practice includes evaluation and adjustment or manipulation of the spine and related structures within the statutory definition. Chiropractors do not prescribe or dispense legend drugs or perform surgery.
Adjunctive procedures
Adjunctive procedures are authorized only for a chiropractor who holds a Board certificate of qualification. Certification requires Board-approved education or training, application, and fee, and must be renewed and displayed as required. Only the procedures listed in the Act and Chapter 21 are authorized-commonly physical modalities such as electrotherapy, ultrasound, thermotherapy, hydrotherapy, and traction. A certificate is not a blanket “physical therapy” license.
Delegation and supervision
Chiropractic assistants may perform administrative and auxiliary tasks but may not perform chiropractic adjustments, evaluative procedures, or adjunctive procedures requiring licensure. The chiropractor remains responsible for training, supervision, and the quality of delegated care.
Documentation and billing
Document the procedure, parameters, patient response, and medical necessity. Bill only for services within the certified scope. Billing for an uncertified procedure is both a scope violation and fraud.
Worked example
A chiropractor without adjunctive certification uses ultrasound. Ultrasound may be an authorized adjunctive procedure, but without the certificate it is outside his legal scope. The violation is not cured by the patient’s consent or a colleague’s verbal approval; he must obtain certification first.
Traps
Assuming the chiropractic license covers all physical modalities; assuming a certificate is permanent; letting assistants adjust; and billing “physiotherapy” when no certified procedure was provided.