DESCRIPTION
Acupuncture is a traditional form of Chinese medical treatment that has been practiced for over 3000 years. Acupuncture involves piercing the skin with needles at specific body sites to induce anesthesia, to relieve pain, to alleviate withdrawal symptoms of substance abusers, or to treat various non-painful disorders (e.g. to relieve nausea/vomiting). In traditional acupuncture, the placement of needles into the skin is dictated by the location of meridians. These meridians are thought to mark patterns of energy flow throughout the human body. The technology has four components - the acupuncture needle(s), the target location defined by traditional Chinese medicine, the depth of insertion, and the stimulation of the inserted needle. The FDA has approved acupuncture needles.
Electroacupuncture (i.e., transcutaneous electrical nerve stimulation [TENS] acupuncture) is the practice of piercing specific body sites with needles that are stimulated by an extremely low voltage of electricity.
POLICY
Acupuncture, in any form, for the treatment of all conditions/diseases is considered investigational.
ADDITIONAL INFORMATION
There is a lack of high-quality randomized controlled trials in peer-reviewed journals regarding acupuncture. There is a tendency to use sham acupuncture control groups with small sample sizes. Questions of efficacy remain. Also, issues of what is an adequate and optional acupuncture procedure remain.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2006). Acupuncture. (7.01.01). Retrieved July 7, 2008 from BlueWeb. (54 articles and/or guidelines reviewed)
Cameron, D., & Gan, T. J. (2003). Management of postoperative nausea and vomiting in ambulatory surgery. Anesthesiology Clinics of North America, 21 (2), 347.
Complete Guide to Medicare Coverage Issues. [Computer software]. (2008, April). Acupuncture - Not covered (NCD 30.3, p. 2-29). St. Anthony Publishing.
Complete Guide to Medicare Coverage Issues. [Computer software]. (2008, April). Acupuncture for fibromyalgia (NCD 30.3.1, p. 2-29). St. Anthony Publishing.
Complete Guide to Medicare Coverage Issues. [Computer software]. (2008, April). Acupuncture for osteoarthritis (NCD 30.3.2, p. 2-30). St. Anthony Publishing.
ECRI Institute. Health Technology Information Service. Windows on Medical Technology. (2006, August). Needle acupuncture for migraine. Retrieved November 1, 2006 from ECRI Institute. (98 articles and/or guidelines reviewed)
Ezzo JM, Richardson MA, Vickers A, Allen C, Dibble SL, Issell BF, Lao L, Pearl M, Ramirez G, Roscoe JA, Shen J, Shivnan JC, Streitberger K, Treish I, Zhang G. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD002285. DOI: 10.1002/14651858.CD002285.pub2.
Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD001351. DOI: 10.1002/14651858.CD001351.pub2.
Hayes. Medical Technology Directory. (2005, January). Acupuncture for the treatment of pain. Retrieved July 7, 2008 from www.Hayesinc.com/subscribers. (46 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2005, June). Acupuncture and acupressure for the treatment of nausea and vomiting. Retrieved July 7, 2008 from www.Hayesinc.com/subscribers. (72 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2005, May). Acupuncture for the treatment of addictive behavior. Retrieved July 7, 2008 from www.Hayesinc.com/subscribers. (70 articles and/or guidelines reviewed)
Koch, K. L., & Frissora, C. L. (2003). Nausea and vomiting during pregnancy. Gastroenterology Clinics, 32 (1), 201-234.
Kundu, A. & Berman. B. (2007). Acupuncture for pediatric pain and symptom management. Pediatric Clinics of North America, 54 (6), 885-889.
Lee, S., Liong, M. L., Yuen, K. H., Leong, W. S., Chee, C., Cheah, P. Y., et al. (2008). Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. The American Journal of Medicine, 121 (1), 79.e1-7. (Level 2 - Industry sponsored)
Manheimer, E., Lim, B., Lao, L., & Berman, B. (2006). Acupuncture for knee osteoarthritis - A randomized trial using a novel sham. Acupuncture in Medicine, 24 (Suppl.), S7-14. (Level 1 - Industry sponsored)
National Guideline Clearinghouse. (2004, December). Acupuncture and electroacupuncture: Evidence-based treatment guidelines. Retrieved July 7, 2008 from http://www.guidelines.gov.
National Guideline Clearinghouse. (2006). Clinical practice guidelines for acupuncture. Retrieved July 7, 2008 from http://www.guidelines.gov.
U. S. Food and Drug Administration. (2003, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K024207. Retrieved July 7, 2008 from http://www.fda.gov/cdrh/pdf2/k024207.pdf.
U. S. Food and Drug Administration. (2006, November). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K061517. Retrieved July 7, 2008 from http://www.fda.gov/cdrh/pdf6/K061517.pdf.
White AR, Rampes H, Campbell JL. Acupuncture and related interventions for smoking cessation. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009. DOI: 10.1002/14651858.CD000009.pub2.
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EFFECTIVE DATE |
8/14/2008 |
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ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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