Cognitive Rehabilitation
Does not apply to Federal Employee Program (FEP).
DESCRIPTION
Cognitive rehabilitation (CR) is a therapeutic approach designed to improve or re-establish cognitive functioning. It is frequently used after central nervous system insult. CR includes therapy methods that retrain or alleviate problems caused by deficits in attention, visual processing, language, memory, reasoning, problem solving, and executive functions. It consists of tasks designed to reinforce or re-establish previously learned patterns of behavior or to establish new compensatory mechanisms for impaired neurological systems. A physician, psychologist, or physical, occupational, or speech therapist may perform cognitive rehabilitation.
Cognitive rehabilitation consists of tasks designed to develop the memory, language, and reasoning skills that can then be applied to specific environments. Sensory integration therapy may be a component of cognitive rehabilitation.
POLICY
Cognitive rehabilitation for the treatment of conditions/diseases, including, but not limited to, the following is considered investigational:
Attention deficit hyperactivity disorder
Autism
Alzheimer’s disease
Cerebral palsy
Dementia
Mental retardation
Parkinson’s disease
Post-encephalitic or post-encephalopathy individuals
Cerebral vascular accident (stroke)
Traumatic brain injury
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
This medical policy does not apply to Federal Employee Program (FEP).
ADDITIONAL INFORMATION
The current available evidence is insufficient to determine the efficacy of using cognitive rehabilitation for the above conditions or diseases.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (2008, April). Cognitive rehabilitation. (8.03.10). Retrieved July 7, 2010 from BlueWeb.
Bowen A, Lincoln NB. Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD003586. DOI: 10.1002/14651858.CD003586.pub2.
Cappa, S. F., Benke, T., Clarke, S., Rossi, B., Stemmer, B., van Heugten, C. M., et al. (2005). EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. European Journal of Neurology, 12 (9), 665 - 680.
Cicerone, K., Dahlberg, C., Malec, J., Langerbahn, D., Felicetti, T., Kneipp, S., et al. (2005). Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86 (8), 1681 - 1692. (Level 5 Evidence)
National Institute for Health and Clinical Excellence. (2008, September). Computerised cognitive behaviour therapy for depression and anxiety. Retrieved July 8, 2010 from http://www.nice.org.uk/nicemedia/live/11568/33185/33185.pdf.
Technology Evaluation Center. (2008, May). Cognitive rehabilitation for traumatic brain injury in adults. (Vol. 25, No. 5). Chicago: BlueCross BlueShield Association. (27 articles and/or guidelines reviewed)
Turner-Stokes L, Disler PB, Nair A, Wade DT. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database of Systematic Reviews 2005, Issue 3. Art. No.: CD004170. DOI: 10.1002/14651858.CD004170.pub2.
Turner Stokes, L. (2008). Evidence for the effectiveness of multi-disciplinary rehabilitation following acquired brain injury: a synthesis of two systematic approaches. Journal of Rehabilitation Medicine, 40 (9), 691 - 701. (Level 2 Evidence)
Winifred S. Hayes, Inc. Medical Technology Directory. (2008, April). Cognitive Rehabilitation for Traumatic Brain Injury. Retrieved July 7, 2010 from www.Hayesinc.com/subscribers. (49articles and/or guidelines reviewed)
ORIGINAL EFFECTIVE DATE: 12/1/2001
MOST RECENT REVIEW DATE: 8/12/2010
ID_BA
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.