Does not apply to Commercial Members
Auricular electrostimulation or auricular electroacupuncture devices involve the stimulation of acupuncture points on the ear by using an electrical pulse rather than a needle or wire. These devices (e.g. AcuStim®, P-Stim®, e-Pulse® UH 900, Elexoma™ Medic, NSS-2 Bridge, Bridge Neurostimulation Device, ANSI Stim®) are worn behind either one or both ears with a pre-programed pulse duration and frequency with an electrode patch placed over the acupuncture points. They have been developed to provide ambulatory electrical stimulation over a period of several days.
Auricular electrostimulation has been proposed as a treatment for a variety of conditions, including the treatment of acute pain from surgical procedures, headaches, acute or chronic pain, osteoarthritis, rheumatoid arthritis, neck pain, insomnia, anxiety, opioid withdrawal, and obesity.
Electrical stimulation of auricular acupuncture points is considered investigational.
Any specific products referenced in this policy are just examples and are intended for illustrative purposes only. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. These examples are contained in the parenthetical e.g. statement.
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.
Does not apply to Commercial Members
There is a lack of evidence to evaluate the effect of auricular stimulation to improve acute and/or chronic pain or any other conditions or to improve health outcomes.
BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2018). Cranial electrotherapy stimulation and auricular electrostimulation (8.01.58). November 16, 2018 from BlueWeb. (19 articles and/or guidelines reviewed)
Schukro, R., Heiserer, C., Michalek-Sauberer, A., Gleiss, A., and Sator-Katzenschlager, S. (2014, February) The effects of auricular electroacupuncture on obesity in female patients--a prospective randomized placebo-controlled pilot study.Complimentary Therapies in Medicine, 22(1), 21-25. Abstract retrieved January 4, 2018 from PubMed database.
Yeh, C., Chiang, Y., Hoffman, S., Liang, Z., Klem, M., Tam, W., et al. (2014). Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2014, Article 934670. (Level 2 evidence - Independent)
U. S. Food and Drug Administration. (2006, March) Center for Devices and Radiologic Health. 510(k) Premarket Notification Database K050123 (AcuStim®). Retrieved January 4, 2018 from http://www.fda.gov.
U. S. Food and Drug Administration. (2009, December) Center for Devices and Radiologic Health. 510(k) Premarket Notification Database K09187S (E-pulse™). Retrieved March 7, 2016 from http://www.fda.gov.
Laing, Y., Xu, B., Zang, X., Zong, L., and Chen, Y. (2014, March) Comparative study on effects between electroacupuncture and auricular acupuncture for methamphetamine withdrawal syndrome. Chinese Acupuncture Journal, 34(3), 219-24. Abstract retrieved January 4, 2018 from PubMed database.
Miranda, A. and Taca A. (2017, February) Neuromodulation with percutaneous electrical nerve field stimulation is associated with reduction in signs and symptoms of opioid withdrawal: a multisite, retrospective assessment. The American Journal of Drug and Alcohol Abuse, 44(1), 56-63. (Level 4 evidence)
ORIGINAL EFFECTIVE DATE: 2/12/2012
MOST RECENT REVIEW DATE: 2/14/2019
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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