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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:__________