WSR 09-17-049



[ Filed August 12, 2009, 11:57 a.m. ]


Title of Policy/Interpretive Statement: Chiropractic Scope of Practice Pertaining to Cold Laser Usage.

Issuing Entity: Chiropractic quality assurance commission (commission).

In order to provide clarity to the public and licensees regarding the use of cold lasers in chiropractic practice, the commission issues this interpretive statement pursuant to RCW 34.05.010(8) and 34.05.230.

Background: Chiropractic has been defined by the legislature in RCW 18.25.005. In part, chiropractic is the practice of health care that deals with the diagnosis or analysis and care or treatment of the vertebral subluxation complex and its effects, articular dysfunction, and musculoskeletal disorders, all for the restoration and maintenance of health and recognizing the recuperative powers of the body.

Chiropractic treatment includes the use of heat/cold and such physiological therapeutic procedures as traction and light, among other modalities. But, chiropractic care specifically does not include the practice of surgery.

The commission has been vested with the authority to adopt rules to establish, monitor, and enforce consistent standards of practice to promote the delivery of quality health care in the state of Washington. The commission has also been vested with the sole authority to discipline Washington state licensed chiropractors for unprofessional conduct regarding failure to maintain an appropriate standard of care or unlawful practice beyond the chiropractic scope.

Pursuant to WAC 246-808-505, the commission has created a classified list of chiropractic procedures and instrumentation. That list presently includes the use of devices termed "cold lasers."

Position: The commission interprets cold lasers as low level therapy lasers that topically penetrate the skin. These devices also include cold laser or low light devices termed "prescriptive devices" by the FDA, pursuant to 21 C.F.R. 801.109.

A chiropractor licensed in the state of Washington may use a cold laser to the extent of the licensee's education and training and for purposes limited to the chiropractic scope of practice as defined in chapter 18.25 RCW and the commission's rules.

Effective Date: April 9, 2009.

Contact Person: Leann Yount, Program Manager, Department of Health, P.O. Box 47852, Olympia, WA 98504-7852, (360) 236-4856.

Washington State Code Reviser's Office