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
ADDITIONAL INFORMATION
There is insufficient scientific evidence to show that biofeedback is an effective treatment for conditions including those considered investigational.
Biofeedback does not meet the following technology evaluation criteria:
The scientific evidence must permit conclusions concerning the effect of the technology on health outcomes.
The technology must improve the net health outcome.
The technology must be as beneficial as any established alternatives.
The improvement must be attainable outside of the investigational settings.
SOURCES
Ballard, K. J., & Robin, D. A. (2007). Influence of continual biofeedback on jaw pursuit-tracking in healthy adults and in adults with apraxia plus aphasia. Journal of Motor Behavior, 39 (1), 19-28. Retrieved April 24, 2007 from PubMed database.
Bisson, E., Contant, B., Sveistrup, H., & Lajoie, Y. (2007). Functional balance and dual-task reaction times in older adults are improved by virtal reality and biofeedback training. Cyberpsychology and Behavior, 10 (1), 16-23. Retrieved April 24, 2007 from PubMed database
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2006). Biofeedback as a treatment of chronic pain (2.01.30). Retrieved April 23, 2007 from BlueWeb.
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2006). Biofeedback as a treatment of fecal incontinence (2.01.64). Retrieved April 23, 2007 from BlueWeb.
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2006). Biofeedback as a treatment of headache (2.01.29). Retrieved April 23, 2007 from BlueWeb.
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2006). Biofeedback as a treatment of urinary incontinence in adults (2.01.27). Retrieved April 23, 2007 from BlueWeb.
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2006). Biofeedback for miscellaneous indications (2.01.53). Retrieved April 23, 2007 from BlueWeb.
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2003). Tempromandibular joint dysfunction (2.01.21). Retrieved April 23, 2007 from BlueWeb.
Chesson, A. L. Jr., Anderson, W. M., Littner, M., Davila, D., Hartse, K., Johnson, S., et al. (1999). Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep, 22 (8), 1128-1133. Abstract retrieved September 1, 2005 from PubMed database.
Complete Guide to Medicare Coverage Issues [Computer software]. (2006, November). Biofeedback therapy (NCD 30.1, p. 2-27). St. Anthony Publishing.
Complete Guide to Medicare Coverage Issues [Computer software]. (2006, November). Biofeedback therapy for the treatment of urinary incontinence (NCD 30.1.1, p. 2-27). St. Anthony Publishing.
Health Technology Assessment Information Service. Technology assessment resource guide for emerging technologies. (2004, October). Biofeedback for urinary incontinence. Retrieved September 1, 2005 from ECRI HTAIS.
Health Technology Assessment Information Service. Windows on medical technology™. (1998, September). Biofeedback for the treatment of constipation in children. Retrieved November 20, 2003 from ECRI HTAIS.
Health Technology Assessment Information Service. Windows on medical technology™. (1998, October). Biofeedback for the treatment of fecal incontinence. Retrieved November 20, 2003 from ECRI HTAIS.
Heumen, A., Scarlett, Y., Jones, K., Ringel, Y., Drossman, D., & Whitehead, W. E. (2007). Randomized, controlled trial shows biofeedback to be superior to alternative treatments for patients with pelvic flood dyssynergia-type constipation. Diseases of the Colon and Rectum, Feb. 7 [Epub ahead of print]. Retrieved April 24, 2007 from PubMed database.
Huntley, A., White, A. R., & Ernst, E. (2002). Relaxation therapies for asthma: A systemic review. Thorax, 57 (2), 127-131. Abstract retrieved November 20, 2003 from PubMed database.
Ilnyckyj, A., Fachnie, E., & Tougas, G. (2005). A randomized-controlled trial comparing an educational intervention alone vs education and biofeedback in the management of fecal incontinence in women. Neurogastroenterology Motility, 17 (1), 58-68. Abstract retrieved September 1, 2005 from PubMed database.
NIH Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia. (1996). Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. JAMA, 1276 (4), 313-318. Abstract retrieved November 20, 2003 from PubMed database.
No authors listed. Comparison of sustained-released nifedipine and temperature biofeedback for treatment of primary Raynaud phenomenon. Results from a randomized clinical trial with 1-year follow-up. (2000). Archives of Internal Medicine, 160 (8), 1101-1108. Abstract retrieved September 1, 2005 from PubMed database.
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. Retrieved April 24, 2007 from PubMed database.
The Technology Evaluation Center. (1996, January). Biofeedback (Vol. 10, No. 25). Chicago: BlueCross BlueShield Association.
The Technology Evaluation Center. (2000, June). Biofeedback in the treatment of urinary incontinence in adults (Vol. 15, No. 5). Chicago: BlueCross BlueShield Association.
U.S. Food and Drug Administration. (2005, August). Center for Devices and Radiological Health. Product classification database. Retrieved September 1, 2005 from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=2414.
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EFFECTIVE DATE |
5/10/2007 |
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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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