Chiropractic offices provide care to a wide spectrum of patients and conditions. Adjusting techniques and treatment modalities vary, ranging from manipulative treatment delivered with the hands to non-force adjustments utilizing instruments to basic rehabilitation exercise all the way to new and advanced technologies.
As a practitioner in my 35th year of clinical practice, I have watched, learned, and tried many treatment delivery systems. The more options I have, the better I feel equipped to handle the variety of patients I see. However, there are challenges that we as chiropractic physicians face every day, which include:
- Complexity and comorbidities of presenting patients
- Time-intensive treatments that require one-on-one doctor time
- Severe muscle spasm limiting some adjusting techniques
- Conditions that initially do not lend themselves to manipulation
- Need to decrease inflammation
- Adjustments “Do Not Hold”
- Decrease in reimbursement
The economic pressures on reimbursement make it essential for us to consider technology that creates additional treatment capabilities that can generate additional revenue for the office.
For decades, low-level laser therapy (LLLT) has been a proven, clinically valid treatment modality for a wide spectrum of musculoskeletal conditions. However, in some respects, laser technology has “stalled” and not kept pace with advancing digital technology. Recently, a new advanced digital laser device has been developed known as “Smart Laser” technology.
Some time ago I became familiar with a new and exciting digital application to laser technology. According to the literature published by the company that invented this technology and my personal experience, this device, marketed under the brand name Willow Curve®, uses a three-phase platform. Phase One gathers sensory data at and below the skin surface and then sends that information to Phase Two. Phase Two utilizes a central processing unit (CPU) that analyzes the sensory data and then creates a “customized digital prescription.” This digital prescription consists of multiple energies. The company calls this dynamic photonic and dynamic thermal kinetic energy formulated in accord with the collected sensory data. Phase Three is the “therapeutic phase” that delivers the customized digital prescription to the skin surface. This digital prescription is composed of multiple parameters (makes sense it carries the “Smart Laser” moniker). These parameters are continuously changing to manipulate the bio-physiologic cellular, chemical, and tissue events that are set in motion by this patient-specific, therapeutic digital prescription. Application of the customized digital prescription engineers manipulation of multiple biochemical and bio-physiological digital processes at the treatment site, which can have a profound effect in producing pain relief and promoting healing.
The “Smart Laser” is designed to treat musculoskeletal pain, and it has been proven to be safe and effective. Due to the characteristics of this digital prescription, therapy with the “Smart Laser” can overcome adaptation by the body, which is the body’s natural mechanism to overcome repeated stimuli. Reducing adaptation fosters ongoing, favorable responses to repeated Willow Curve® treatments. It also contributes to promoting cumulative benefits with ongoing use of the device, including but not limited to a reduction of inflammation. This is one of the major advantages of this digital anti-inflammatory medical device.
I have observed that the great majority of treatments administered, with or without coincident manipulative therapy, produce pain reduction, increased mobility, and decreased tissue edema, along with increased patient comfort during manipulation. I have observed no adverse side effects.
This new “Smart Laser” offers our profession additional financial value. It allows us to treat conditions that normally are not treatable with adjustments alone. This could increase billable treatments, patient referrals, and patient census. For example, I have heard, “Hey, you should go see Dr. Deb; she’s got this new laser that works wonders.”
Also, I understand the company was recently awarded a device-specific Willow Curve® CPT code by the AMA CPT Editorial Panel. Billing is the life blood of our profession, and this creates some interesting opportunities for increasing our office revenue. This code is described as low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional. The code will be electronically available on the AMA website January 1, 2019 and will be published in the CPT code manual in 2019. Additionally, I am aware that there are chiropractic physicians using current codes and receiving reimbursement. They are also submitting supplemental information regarding the diagnosis and treatment and the medical necessity.
97112 Neuromuscular reeducation (approx. 28.60 mac) (approx. 35)
97140 Myofascial release 28.35 mac 35
97530 Therapeutic exercise 29.00 mac 35
I view the Willow Curve® “Smart Laser” integration practice benefits as follows:
- Expand the spectrum of treatments, i.e., conditions too inflamed to adjust
- Increase mobility and facilitate manipulation
- Enhance patient comfort with manipulation
- Safe and effective
- Decrease recovery time
- Increase practice revenue with low barrier of entry to offer LLLT
- Increase practice revenue by administering billable “Smart Laser” LLLT treatments
- Increase practice revenue by new patient referral
- Direct sale to patient
- “Smart Laser” technology can facilitate rapid home rehabilitation for modest cost to the patient and overall cost savings
I now have the ability to treat these challenging clinical conditions with virtually no risk of side effects. My clinical results correlate to the research data from the company that reported 90+% favorable treatment outcomes in over 1 million treatments with a patient population of over 50,000.
F Ceccherelli,, Altafini L, Avila GC. Clin J Pain. 1989 Dec;5(4):301-4.
 Chelucci KM, et. al, Clinical Evaluation of a Non- Invasive Technology for the Treatment of Chronic Joint Symptoms. Journal of Orthopedic Research and Review. Vol. 2013:5, January 2013; 5-11.
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