Page 21 - Medicare Benefit Policy Manual

limited safety data are compiled. Depending on the lens being evaluated, the adjunct
study may be an extension of the core study or may be the only type of investigation to
which the lens may be subject.

All eye care services related to the investigation of the IOL must be provided by the
investigator (i.e., the implanting ophthalmologist) or another practitioner (including a
doctor of optometry) who provides services at the direction or under the supervision of
the investigator and who has an agreement with the investigator that information on the
patient is given to the investigator so that he or she may report on the patient to the IOL
manufacturer.

Eye care services furnished by anyone other than the investigator (or a practitioner who
assists the investigator, as described in the preceding paragraph) are not covered during
the period the IOL is being investigated, unless the services are not related to the
investigation.

B. Concurrent Care

Where more than one practitioner furnishes concurrent care, services furnished to a
beneficiary by both an ophthalmologist and another physician (including an optometrist)
may be recognized for payment if it is determined that each practitioner’s services were
reasonable and necessary. (See §30.E.)

30.5 - Chiropractor’s Services
(Rev. 23, Issued: 10-08-04, Effective: 10-01-04, Implementation: 10-04-04)
B3-2020.26

A chiropractor must be licensed or legally authorized to furnish chiropractic services by
the State or jurisdiction in which the services are furnished. In addition, a licensed
chiropractor must meet the following uniform minimum standards to be considered a
physician for Medicare coverage. Coverage extends only to treatment by means of
manual manipulation of the spine to correct a subluxation provided such treatment is
legal in the State where performed. All other services furnished or ordered by
chiropractors are not covered.

If a chiropractor orders, takes, or interprets an x-ray or other diagnostic procedure to
demonstrate a subluxation of the spine, the x-ray can be used for documentation.
However, there is no coverage or payment for these services or for any other diagnostic
or therapeutic service ordered or furnished by the chiropractor. For detailed information
on using x-rays to determine subluxation, see §240.1.2.

In addition, in performing manual manipulation of the spine, some chiropractors use
manual devices that are hand-held with the thrust of the force of the device being
controlled manually. While such manual manipulation may be covered, there is no
separate payment permitted for use of this device.