POLICY STATEMENT on INFRARED IMAGING

Approved by the ACA House of Delegates June 13, 1991;
Terminology updated by HOD August 27, 1999

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High Resolution Infrared (HRI) Imaging is a diagnostic procedure which measures skin surface temperature.  It is germane to chiropractic practice in cases where a physiologic test is required for the diagnosis of selected neurological and musculoskeletal conditions.  High Resolution Infrared Imaging requires a high level of operator and interpreter competency and an adherence to established and consistent protocol.  The results of High Resolution Infrared Imaging must be properly correlated with a thorough history, an appropriate clinical examination, and other diagnostic studies/tests as may be indicated by clinical necessity.  In this setting, High Resolution Infrared Imaging may be an aid in establishing a differentiated diagnosis and in determining a prognosis.

GUIDELINES FOR INFRARED IMAGING IN CHIROPRACTIC PRACTICE

Description

Infrared Imaging is a diagnostic procedure which measures skin surface temperature distribution.

Policy

This diagnostic imaging procedure is germane to chiropractic practice in cases where a physiologic test is required.  High Resolution Infrared (HRI) Imaging is a useful procedure for the diagnosis of selected neurological and musculoskeletal conditions.

Guidelines for Determining Medical Necessity

The treating doctor shall certify as to the medical necessity for infrared imaging based upon a diagnostic clinical question and the effect of the results on case management decisions. The referring doctor shall certify to the medical necessity by prescription.  HRI Imaging is of value in the diagnostic evaluation of patients when the clinical history suggests the presence of one of the following situations:

1.   Early diagnosis and monitoring of reflex sympathetic dystrophy (Complex Regional Pain Syndrome, Type I).

2.   Evaluation of spinal nerve root/fiber irritation and distal peripheral nerve fiber pathology for detection of sensory/autonomic dysfunction.

3.   To evaluate and monitor soft tissue injuries, including segmental dysfunction/subluxation, sprain, and myofascial conditions (strains and myofascial pain syndromes) not responding to clinical treatment.

4.   To evaluate for the physiological significance of equivocal or minor anatomical findings seen on CT and/or MRI.

5.   To evaluate for feigned disorders.

Utilization Review

Because of the detailed knowledge, training, and skill level required, infrared imaging studies ordered, produced, or interpreted by chiropractic physicians must be reviewed only by a licensed chiropractor who holds appropriate** credentials with regard to knowledge, skill, and experience in infrared imaging.  Only licensed chiropractors holding such credentials can claim sufficient competence to make valid judgments or comments regarding appropriateness, necessity, or accuracy of infrared imaging studies, and their relevance to chiropractic case management.

**         Board Certified status with the American Chiropractic Board of Infrared Imaging or other national thermographic certifying board which restricts its examination to candidates who have completed a prescribed postgraduate syllabus program offered by a chiropractic college having status with a national chiropractic accrediting agency approved by the United States Department of Education (USDE).