Biofeedback
DESCRIPTION
Biofeedback is a technique used to train an individual to control a physiological process. It uses cognitive and behavioral techniques to teach an individual self-regulation of biologic processes. Various measuring and recording instruments and monitors may be used in the training. Biofeedback training is done in individual sessions, group sessions, alone or with other behavioral therapies designed to teach relaxation. The entire program usually consists of 10 to 20 training sessions that last about 30 minutes each. Biofeedback has been proposed as a treatment for a variety of diseases and disorders including anxiety, headache (e.g., migraine and tension), hypertension, fecal incontinence, urinary incontinence, pain, asthma, Raynaud's disease, insomnia, and temporomandibular joint dysfunction.
POLICY
Biofeedback training or therapy for all conditions including, but not limited to, the following is considered investigational:
Asthma
Chronic pain
Constipation
Fecal incontinence
Headache
Hypertension
Insomnia
Movement disorders
Raynaud's disease
Urinary incontinence
Any device utilized for this procedure must have FDA approval specific to the indication, otherwise it will be considered investigational.
ADDITIONAL INFORMATION
There is insufficient scientific evidence to show that biofeedback is an effective treatment for conditions including those considered investigational.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (11:2008). Biofeedback as a treatment of chronic pain (2.01.30). Retrieved February 25, 2009 from BlueWeb. (16 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2008). Biofeedback as a treatment of fecal incontinence (2.01.64). Retrieved February 25, 2009 from BlueWeb. (30 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (5:2007). Biofeedback as a treatment of headache (2.01.29). Retrieved February 25, 2009 from BlueWeb. (12 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2008). Biofeedback as a treatment of urinary incontinence in adults (2.01.27). Retrieved February 25, 2009 from BlueWeb. (24 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (5:2007). Biofeedback for miscellaneous indications (2.01.53). Retrieved February 25, 2009 from BlueWeb. (11 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2003). Temporomandibular joint dysfunction (2.01.21). Retrieved February 25, 2009 from BlueWeb. (0 articles and/or guidelines reviewed)
Bols, E. M., Berghmans, B. C., Hendriks, E. J., de Bie, R. A., Melenhorst, J., van Gemert, W. G., et al. (2007). A randomized physiotherapy trial in patients with fecal incontinence: design of the PhysioFIT-study. BMC Public Health, 7, 355. (Level 2 Evidence - Industry sponsored)
Complete Guide to Medicare Coverage Issues [Computer software]. (2008, November). Biofeedback therapy (NCD 30.1, p. 2-28). The Ingenix Complete Guide to Medicare Coverage Issues.
Complete Guide to Medicare Coverage Issues [Computer software]. (2008, November). Biofeedback therapy for the treatment of urinary incontinence (NCD 30.1.1, p. 2-29). The Ingenix Complete Guide to Medicare Coverage Issues.
Demirturk, F., Akbayrak, T., Karakaya, I. C., Yuksel, I., Kirdi, N., Demirturk, F., et al. (2008). Interferential current versus biofeedback results in urinary stress incontinence. Swiss Medical Weekly, 138 (21-22), 317-321. (Level 3 Evidence - Independent study)
ECRI Institute. Health Technology Information Service. Evidence Reports. (1998, September). Biofeedback for the treatment of constipation in children. Retrieved February 25, 2009 from ECRI Institute. (32 articles and/or guidelines reviewed)
ECRI Institute. Health Technology Information Service. Evidence Reports. (1998, October). Biofeedback for the treatment of fecal incontinence. Retrieved February 25, 2009 from ECRI HTAIS. (40 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2004, November). Biofeedback for headache and chronic musculoskeletal pain. Retrieved February 25, 2009 from www.Hayesinc.com/subscribers. (47 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2006, February). Biofeedback for the treatment of hypertension. Retrieved February 25, 2009 from www.Hayesinc.com/subscribers. (25 articles and/or guidelines reviewed)
Hayes. Medical Technology Directory. (2006, February). Biofeedback therapy for vulvodynia. Retrieved February 25, 2009 from www.Hayesinc.com/subscribers. (30 articles and/or guidelines reviewed)
National Guideline Clearinghouse. (2008, March). Prevention of fecal and urinary incontinence in adults. Retrieved February 25, 2009 from http://www.guidelines.gov.
Norton, C. (2008). Fecal incontinence and biofeedback therapy. Gastroenterology Clinics of North America, 37 (3), 587-604.
Rao, S. S., Seaton, K., Miller, M., Brown, K., Nygaard, I., Stumbo, P., et al. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clinical Gastroenterology and Hepatology, 5 (3), 331-338. (Level 2 Evidence - Industry sponsored)
U. S. Food and Drug Administration. (2005, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K050483. Retrieved February 25, 2009 from http://www.fda.gov/cdrh/pdf5/K050483.pdf.
ORIGINAL EFFECTIVE DATE: 4/1980
MOST RECENT REVIEW DATE: 4/9/2009
ID_BT
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