Biofeedback
Biofeedback policy statements do not apply to Medicare Advantage.
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.
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.
Biofeedback policy statements do not apply to Medicare Advantage.
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. (1:2003). Temporomandibular joint dysfunction (2.01.21). Retrieved May 4, 2010 from BlueWeb. (0 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (7:2009). Biofeedback as a treatment of urinary incontinence in adults (2.01.27). Retrieved May 4, 2010 from BlueWeb. (29 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (4:2009). Biofeedback as a treatment of headache (2.01.29). Retrieved May 4, 2010 from BlueWeb. (17 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2010). Biofeedback as a treatment of chronic pain (2.01.30). Retrieved May 4, 2010 from BlueWeb. (20 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (8:2009). Biofeedback for miscellaneous indications (2.01.53). Retrieved May 4, 2010 from BlueWeb. (16 articles and/or guidelines reviewed)
BlueCross BlueShield Association. Medical Policy Reference Manual. (2:2009). Biofeedback as a treatment of fecal incontinence (2.01.64). Retrieved May 4, 2010 from BlueWeb. (30 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)
Campbell, J. K., Penzien, D. B., Wall, E. M., & U. S. Headache Consortium. (2000). Evidenced-based guidelines for migraine headache: Behavioral and physical treatments. Retrieved May 4, 2010 from http://www.aan.com/professionals/practice/pdfs/gl0089.pdf.
Complete Guide to Medicare Coverage Issues [Computer software]. (2010, April). Biofeedback therapy (NCD 30.1, p. 2-29). The Ingenix Complete Guide to Medicare Coverage Issues.
Complete Guide to Medicare Coverage Issues [Computer software]. (2010, April). 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 May 4, 2010 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 May 4, 2010 from ECRI HTAIS. (40 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. (2008, March). Biofeedback therapy for vulvodynia. Retrieved April 28, 2010 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 May 4, 2010 from http://www.guidelines.gov.
National Institute of Neurological Disorders and Stroke. National Institute of Health. (2010, May). Headache: Hope through research. Retrieved May 10, 2010 from http://www.ninds.nih.gov/disorders/headache/detail_headache.htm.
National Institute of Neurological Disorders and Stroke. National Institute of Health. (2010, March). Condensed from headache: Hope through research. Retrieved April 29, 2010 from http://www.ninds.nih.gov/disorders/headache/headache.htm.
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)
Silberstein, S. D. (2000). Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 55 (6), 754-762.
U. S. Food and Drug Administration. (2005, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K050483. Retrieved May 4, 2010 from http://www.accessdata.fda.gov/cdrh_docs/pdf5/K050483.pdf.
ORIGINAL EFFECTIVE DATE: 4/1980
MOST RECENT REVIEW DATE: 7/22/2010
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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