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 other 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
ADDITIONAL INFORMATION
The available evidence is insufficient to draw conclusions regarding the efficacy of cognitive rehabilitation.
SOURCES
BlueCross BlueShield Association. Medical Policy Reference Manual. (2008, April). Cognitive rehabilitation. (8.03.10). Retrieved December 22, 2008 from BlueWeb.
Bowen A, Lincoln N. B., & Dewey M. Cognitive rehabilitation for spatial neglect following stroke. The Cochrane Database of Systematic Reviews. In The Cochrane Library, Issue 2, 2005. Oxford: Update Software.
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. Abstract retrieved January 10, 2007 from PubMed database.
Cicerone, K. D., Dahlberg, C., Malec, J. F., Langerbahn, D. M., 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. Abstract retrieved January 10, 2007 from PubMed database.
ECRI Institute. Health Technology Information Service. Evidence Reports. (2007, November). Cognitive Rehabilitation Therapy for Traumatic Brain Injury. Retrieved December 22, 2008 from ECRI Institute. (110 articles and/or guidelines reviewed)
Hayes Medical Technology Directory. (2008, April). Cognitive Rehabilitation for Traumatic Brain Injury. Retrieved December 22, 2008 from www.Hayesinc.com/subscribers. (49articles and/or guidelines reviewed)
Riverbend: Government Benefits Administrator. Local Coverage Determinations (LCDs). (2008, August). LCD for inpatient rehabilitation (L22951). Retrieved December 26, 2008 from http://www.rgbagov.com/publications/lcd/lcd-files/22951.html.
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.
ORIGINAL EFFECTIVE DATE: 12/1/2001
MOST RECENT REVIEW DATE: 2/12/2009
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.
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