BlueCross BlueShield of Tennessee Medical Policy Manual

Complementary and Alternative Medicine


Complementary and alternative medicine (CAM), as defined by the National Center for Complementary and Integrative Health (NCCIH), is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Therapies and diagnostics are termed “complementary” when used in addition to conventional medicine while therapies and diagnostics used in place of conventional medicine are considered “alternative”. Complementary health approaches typically include natural products, mind and body practices, and the practices of traditional healers (e.g., Chinese medicine, homeopathy and naturopathy).

Integrative Medicine (IM) combines state of the art conventional medicine with alternative modalities to stimulate the body's natural healing potential. IM is based upon a model of health and wellness, as opposed to a model of disease. It seeks to care for the whole person by taking into account the many interrelated physical and nonphysical factors that affect health, wellness, and disease.




While scientific evidence exists for some CAM therapies and diagnostics, for most there are key questions that are yet to be answered through well-designed scientific studies. Systematic reviews of traditional Chinese medicine were inconclusive due specifically to poor methodology and heterogeneity of the studies.

Complementary and alternative medicine including, but not limited to, those listed above, do not meet the following Technology Evaluation Center (TEC) criteria:


Ali, A., Njike, V., Northrup, V., Sabina, A., Williams, A., Liberti, L., Perlman, A., et al. (2009). Intravenous micronutrient therapy (Myers’ cocktail) for fibromyalgia: a placebo-controlled pilot study. Journal of Alternative and Complementary Medicine, 15 (3), 247-257. (Level 2 evidence)

American Academy of Allergy, Asthma & Immunology. (2014). Food allergy: a practice parameter update - 2014. Retrieved November 10, 2017 from

American Cancer Society. (2017). Complementary and alternative methods and cancer. Retrieved November 13, 2017 from

American College of Medical Genetics and Genomics (ACMG). (2013, February). ACMG practice guideline: lack of evidence for MTHR polymorphism testing. Retrieved November 9, 2017 from

American College of Obstetricians and Gynecologists. (2007, reaffirmed 2017). Vaginal “rejuvenation” and cosmetic vaginal procedures. ACOG Committee Opinion Number 378. Retrieved November 6, 2017 from

American College of Obstetrics and Gynecologists. (2012, reaffirmed 2016). Compounded Bioidentical Menopausal Hormone Therapy. Committee Opinion No. 532: Retrieved November 7, 2017 from

American Society of Plastic Surgeons. (2012). The vampire facelift: not really a face lift and no vampires involved. Retrieved November 6, 2017 from

Atalay, N., Sahin, F., Atalay, A., & Akkaya, N. (2013). Comparison of efficacy of neural therapy and physical therapy in chronic low back pain. African Journal of Traditional, Complementary and Alternative Medicines, 10 (3), 431-435. (Level 3 evidence)

BlueCross BlueShield Association. Evidence Positioning System. (11:2017). Neural therapy (2.01.85). Retrieved October 12, 2018 from  (8 guidelines and/or articles reviewed)

BlueCross BlueShield Association. Evidence Positioning System. (7:2018). Miscellaneous genetic and molecular diagnostic tests (2.04.121). Retrieved October 12, 2018 from  (60 articles and/or guidelines reviewed)

BlueCross BlueShield Association. Medical Policy Reference Manual. (10:2017). Antigen leukocyte antibody test (2.01.93). Retrieved November 7, 2017 from BlueWeb. (8 guidelines and/or articles reviewed)

Jiménez, M., & Molina Mora, J. (2017). Effect of heart rate variability biofeedback on sport performance, a systematic review. Applied Psychophysiology and Biofeedback, 2017 June 1, doi: 10.1007/s10484-017-9364-2. [Epub ahead of print]. Abstract retrieved November 7, 2017 from PubMed database.

National Institute of Allergy and Infectious Diseases. (2010) Guidelines for the diagnosis and management of food allergy in the United States. Retrieved July 16, 2012 from

National Institutes of Health. National Center for Complementary and Integrative Health. (2017). Health topics A – Z. Retrieved November 10, 2017 from

Seely, D., Szczurko, O., Cooley, K., Fritz, H., Aberdour, S., Herrington, C., Herman, P., et al. (2013). Naturopathic medicine for the prevention of cardiovascular disease: a randomized clinical trial. Canadian Medical Association Journal, 185 (9), E409-E416. (Level 2 evidence)

Tennessee Code: Title 63 Professions of the Healing Arts: Chapter 6 Medicine and Surgery: Part 2 General Provisions: 63-6-205. Practice of naturopathy. Retrieved October 12, 2018 from

U. S. Food and Drug Administration. (2011, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K101867. Retrieved July 3, 2012 from

United States Department of Labor. Occupational Safety and Health Administration. (2017). Multiple chemical sensitivities. Retrieved November 16, 2017 from

Villafaina, S., Collado-Mateo, D., Fuentes, J., Merellano-Navarro, E., & Gusi, N. (2017). Physical exercise improves heart rate variability in patients with type 2 diabetes: a systematic review. Current Diabetes Reports, 17 (11), 110. Abstract retrieved November 7, 2017 from PubMed database.




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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