| Coverage Policy Manual | |
| Policy #: | 1998011 |
| Category: | Alternative Medicine |
| Initiated: | January 1993 |
| Last Review: | December 2023 |
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| Acupuncture | |
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| Description: |
Acupuncture is a traditional form of Chinese medical treatment that has been practiced for over 3,000 years.
Acupuncture is the practice of piercing the skin with needles at specific body sites to induce anesthesia, to relieve pain, to alleviate withdrawal symptoms of substance abusers, or to treat various non-painful disorders. In acupuncture, the placement of needles into the skin is dictated by the location of meridians. These meridians are thought to mark patterns of energy flow throughout the human body. Acupuncture has four components - the acupuncture needle(s), the target location defined by traditional Chinese medicine, the depth of insertion, and the stimulation of the inserted needle.
Electroacupuncture, or transcutaneous electrical nerve stimulation (TENS) acupuncture, is the practice of piercing specific body sites with needles that are stimulated by an extremely low voltage of electricity.
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Policy/ Coverage: |
Acupuncture is a contract exclusion in some member benefit certificates of coverage. The following Policy/Coverage statements apply to those members with contracts without this exclusion.
Effective December 2020
Meets Primary Coverage Criteria Or Is Covered For Contracts Without Primary Coverage Criteria
Acupuncture for the treatment of nausea associated with surgery, chemotherapy, and pregnancy meets primary coverage criteria of effectiveness in improving health outcomes.
Does Not Meet Primary Coverage Criteria Or Is Investigational For Contracts Without Primary Coverage Criteria
Acupuncture (any form) for any indication not listed above, including but not limited to acupuncture for the treatment of pain, does not meet primary coverage criteria of effectiveness in improving health outcomes.
For members with contracts without primary coverage criteria acupuncture (any form) for any indication not listed above, including but not limited to acupuncture for the treatment of pain, is considered investigational. Investigational services are specific contract exclusions in most member benefit certificates of coverage.
Effective Prior to December 2020
Any form of acupuncture, including acupuncture for the treatment of pain, is not covered due to an exclusion in the member certificate of coverage.
For member benefit certificates without this specific exclusion, acupuncture may be considered medically necessary for treatment of nausea associated with surgery, chemotherapy, and pregnancy.
For member benefit certificates without this specific exclusion, acupuncture for any other indication, including but not limited to acupuncture for the treatment of pain, is considered investigational.
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| Rationale: |
2014 Update
A literature search conducted through July 2014 did not reveal any new information that would prompt a change in the coverage statement.
2018 Update
Annual policy review completed with a literature search using the MEDLINE database through June 2018. No new literature was identified that would prompt a change in the coverage statement.
2019 Update
A literature search was conducted through July 2019. There was no new information identified that would prompt a change in the coverage statement
2020 Update
Annual policy review completed with a literature search using the MEDLINE database through July 2020. No new literature was identified that would prompt a change in the coverage statement.
2020 Update
Annual policy review completed with a literature search using the MEDLINE database through November 2020. No new literature was identified that would prompt a change in the coverage statement. The key identified literature is summarized below.
Lam et al conducted a systematic review and meta-analysis of RCTs to evaluate the effectiveness of acupuncture for nonspecific chronic low back pain (Lam, 2013). Among the 32 studies included in the systematic review, 25 studies presented relevant data for meta-analysis. Reviewers adopted a minimally important change of 15 mm in VAS score, 2 points for numeric pain scale score for pain, 5 points for Roland-Morris Disability Questionnaire score, and 10 points for Oswestry Disability Index score for pooled results that use the same outcome scales (ie, mean difference) to determine if an intervention had a clinically significant effect on pain. Acupuncture had a clinically meaningful reduction in levels of self-reported pain compared with sham and improved function when compared with no treatment in the immediate postintervention period. Levels of function also improved clinically when acupuncture plus usual care was compared with usual care alone. When acupuncture was compared with medications (nonsteroidal anti-inflammatory drugs, muscle relaxants, analgesics) and usual care, there were statistically significant differences between the control and the intervention groups, but these differences were too small to be of any clinical significance.
A systematic review performed by Chou et al included the Lam et al meta-analysis described above and found 4 additional RCTs pertaining to acupuncture for chronic low back pain (Chou, 2017). However, no updated meta-analysis was performed. Only 1 of the additional trials was considered "good quality." This trial found improved pain scores after 6 weeks with acupuncture versus sham acupuncture, but no significant differences in Oswestry Disability Index score.
Various Cochrane reviews have found insufficient evidence to demonstrate that acupuncture is effective for treating shoulder pain, lateral elbow pain, carpal tunnel syndrome, hip osteoarthritis, cancer pain in adults, chronic pain in patients with spinal cord injury, pain in endometriosis, and pain in rheumatoid arthritis (Green, 2005; Green, 2002; O’Connor, 2003; Choi, 2018; Manheimer, 2018; Paley, 2015; Boldt, 2014; Zhu, 2011; Casimiro, 2005). These reviews identified few RCTs, low-quality RCTs, and/or lack of significantly better outcomes with acupuncture than with control conditions.
He et al published an additional systematic review and meta-analysis on acupuncture for cancer pain (He, 2020). Seven sham-controlled trials were identified, and a meta-analysis of data from these trials found that true acupuncture reduced pain more than sham acupuncture (mean difference, −1.38 points; 95% CI, −2.13 to −0.64). However, heterogeneity was high (I2=81%), and the clinical significance of the difference between groups is uncertain. No analyses were performed to compared true acupuncture to other active interventions.
Bahrami-Taghanaki et al performed an RCT in 49 patients comparing acupuncture to celecoxib treatment for carpal tunnel syndrome (Bahrami-Taghanaki, 2020). Although patients receiving acupuncture had lower pain and symptom scores than patients receiving celecoxib both immediately postintervention and at the 3-month follow-up visit, these differences were unlikely to be clinically significant. Additionally, the trial was unblinded, so outcomes may have been influenced by knowledge of group assignment.
Li et al reported an additional single-blind RCT in 134 patients undergoing chemotherapy (Li, 2020). Patients were randomized to receive true acupuncture (n=68) or sham acupuncture (n=66) in addition to antiemetics. Interventions were administered twice on day 1 of chemotherapy, then daily for the next 4 days. The rates of complete response of nausea or vomiting did not differ significantly between groups at any time point during the 21-day follow-up period, except at day 21, where the true acupuncture group exhibited a higher complete response rate for nausea (83.9% versus 67.2%, p=0.033).
Eccleston et al published a Cochrane review of interventions for reducing prescribed opioid use in patients with chronic non-cancer pain who had a treatment goal of reduction or cessation of opioid use (Eccleston, 2017). Selection criteria included RCTs comparing interventions with sham, active control, or usual care. One RCT on acupuncture was identified. It compared 6 weeks of electroacupuncture (n=17) with sham electroacupuncture (n=18). At the end of treatment, 64% of the electroacupuncture group and 46% of the sham group had reduced opioid consumption; the difference between groups was not statistically significant. At the 20-week follow-up, patients in the electroacupuncture group, but not the sham group, had significantly increased opioid use from their post-treatment level.
Other than the Eccleston et al review, no Cochrane reviews were identified on acupuncture in opioid users (Eccleston, 2017).
The 2019 guidelines from the American College of Rheumatology on the treatment of osteoarthritis conditionally recommend acupuncture for patients with hip, knee, and/or hand osteoarthritis (Kolasinski, 2020). Guideline authors note that the evidence for efficacy of acupuncture in osteoarthritis remains a subject of controversy. The greatest number of positive trials with the largest effect sizes have been in patients with knee osteoarthritis. The authors conclude: "While the ‘true’ magnitude of effect is difficult to discern, the risk of harm is minor, resulting in the Voting Panel providing a conditional recommendation."
A guideline from the American College of Physicians (2017) strongly recommends nonpharmacologic therapy for the initial treatment of chronic low back pain: this may include "exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation (low-quality evidence)" (American College of Physicians, 2017).
The Department of Veterans Affairs/Department of Defense guideline on the primary care management of headache found insufficient evidence to recommend for or against acupuncture for the treatment of headache (VA/DoD, 2020). According to guideline authors, "evidence suggests small or inconsistent benefits for migraine and tension-type headache in comparison to sham acupuncture." The Department of Veterans Affairs/Department of Defense guideline on the non-surgical management of hip and knee osteoarthritis found insufficient evidence to recommend for or against the use of acupuncture in this setting (VA/DoD, 2020).
The Department of Veterans Affairs/Department of Defense guideline on the treatment of low back pain suggests offering acupuncture to patients with chronic low back pain (VA/DoD, 2017). The authors state: "Acupuncture appears to help patients in the long term (3 to 6 months). There is moderate quality evidence based on 2 trials to support the use of acupuncture for modest long-term improvements in disability and the perceived impact of pain associated with chronic low back pain." For acute low back pain, there was insufficient evidence to support the use of acupuncture.
The North American Spine Society guideline on low back pain states that "in patients with low back pain, there is conflicting evidence that acupuncture provides improvements in pain and function as compared to sham acupuncture" (North American Spine Society, 2020). However, the guideline recommends acupuncture in addition to usual care in patients with chronic low back pain, stating that "addition of acupuncture to usual care is recommended for short-term improvement of pain and function compared to usual care alone."
Centers for Medicare & Medicaid Services issued a 2003 national coverage analysis of acupuncture for fibromyalgia and a 2003 decision analysis on acupuncture for osteoarthritis, both indicating noncoverage of the service (CMS, 2003). National coverage determinations for acupuncture for fibromyalgia and osteoarthritis were updated in January 2020 but continue to indicate noncoverage of the service for these disease states (CMS, 2020).
2021 Update
Annual policy review completed with a literature search using the MEDLINE database through November 2021. No new literature was identified that would prompt a change in the coverage statement. The key identified literature is summarized below.
Giovanardi et al completed a more recent systematic review and meta-analysis that evaluated the efficacy and safety of acupuncture versus pharmacological prophylaxis of migraine (Giovanardi, 2020). The review included 9 RCTs. Results were similar with the authors concluding that acupuncture is mildly more effective and much safer than medication for the prophylaxis of migraine.
Kolokotsios et al conducted a systematic review and meta-analysis of 15 trials (N=1267) that evaluated the effectiveness of acupuncture on headache intensity and frequency in patients with tension-type headache (Kolokotsios, 2021). Of the included studies, only 4 met the inclusion criteria for the meta-analysis (n=557). The average number of acupuncture sessions per patient in these studies was 9 and the average duration of treatment was 5.5 weeks. Results revealed that headache frequency after the last treatment was not significantly lower in the acupuncture group versus the placebo/sham group (mean difference, -1.53; 95% CI, -4.73 to 1.67); however, there was a trend toward improvement in the frequency of headaches in the long term (p=.06). Additionally, the VAS score was slightly reduced in the acupuncture group as compared with control after the last treatment (mean difference, -0.29; 95% CI, -1.21 to 0.62; p=.53). Long term, acupuncture was associated with a significant reduction in VAS (mean difference, -0.41; 95% CI, -0.72 to -0.10; p=.009).
An updated Cochrane review by Mu et al included 33 RCTs (N=8270) that assessed the effects of acupuncture compared to sham intervention, no treatment, or usual care for chronic nonspecific low back pain in adults with pain lasting more than 3 months without a specific etiology (Mu, 2020). The primary outcomes were pain, back-specific functional status, and quality of life. Overall, the majority of studies had a high risk of performance bias due to lack of blinding and a few studies had a high risk of detection, attrition, reporting, or selection bias. Overall, the authors concluded that acupuncture may not play a more clinically meaningful role than sham in relieving pain immediately after treatment or in improving quality of life in the short term, and acupuncture did not improve back function compared to sham in the immediate term. However, acupuncture was more effective than no treatment in improving pain and function in the immediate term.
Huang et al conducted a systematic review and meta-analysis that analyzed the efficacy and safety of acupuncture for the treatment of chronic spinal pain (Huang, 2021). The review included 22 RCTs with 2,588 patients who had chronic neck pain, chronic low back pain, or sciatica for more than 3 months. Any type of acupuncture therapy was included in the systematic review/meta-analysis such as traditional acupuncture, electro-acupuncture, fire needling, auricular acupuncture, abdominal acupuncture, warm acupuncture, and bee venom acupuncture. Control interventions included usual care, no treatment, sham acupuncture, placebo, or pharmacologic therapies. The primary outcome was pain intensity. Overall, standard acupuncture was utilized in 16 studies, the duration of interventions ranged from 1 treatment to 8 weeks of treatment, and follow-up ranged from 2 weeks to 1 year after the final treatment. A pooled analysis revealed acupuncture to significantly improve chronic spinal pain as compared to sham acupuncture (weighted mean difference [WMD], -12.05; 95% CI, -15.86 to -8.24), usual care (WMD, -9.57; 95% CI, -13.48 to -9.44), and no treatment (WMD, -17.1; 95% CI, -24.83 to -9.37). Acupuncture was also associated with improvement in physical functioning at short-, intermediate-, and long-term follow-up. Of note, the meta-analysis had significant heterogeneity, which may have been due to the differing forms of acupuncture utilized and quality of included studies. Additionally, the majority of included trials had only short- and intermediate-term follow-up data and a relatively small sample size. Blinding of treatment was also difficult due to the nature of acupuncture therapy.
Zheng et al performed a systematic review and meta-analysis involving 10 trials (9 RCTs and 1 prospective cohort) that evaluated the effectiveness of acupuncture therapy on PONV after gynecologic surgery (Zheng, 2021). A total of 1,075 women who had undergone gynecologic surgery with general anesthesia were included. Included studies evaluated the use of acupuncture and its derived techniques (eg, transcutaneous acupoint electrical stimulation, acupressure, and acupoint application) versus placebo or sham acupuncture. Primary outcomes of the analysis included the incidence of postoperative nausea and the incidence of postoperative vomiting. Results revealed that acupuncture therapy was associated with a significant reduction in the risk of developing postoperative nausea and postoperative vomiting by 48% (RR, 0.52; 95% CI, 0.44 to 0.61; p<.00001) and 42% (RR, 0.58; 95% CI, 0.49 to 0.68; p<.00001), respectively. There were no significant differences between groups with regard to the incidence of adverse effects (eg, bleeding and needle pain; p=.54). Acupuncture therapy was also significantly associated with a reduced rate of rescue antiemetic usage (p<.00001) and an increased degree of satisfaction with postoperative recovery (p<.0001). The authors concluded that acupuncture therapy is effective and safe for PONV prophylaxis in patients undergoing gynecologic surgery; however, a large, multicenter study is still required to compare the effects of acupuncture on preventing PONV with other noninvasive acupoint stimulation techniques.
2022 Update
Annual policy review completed with a literature search using the MEDLINE database through November 2022. No new literature was identified that would prompt a change in the coverage statement. The key identified literature is summarized below.
A network meta-analysis by Wen et al investigated the impact of acupuncture in individuals with opioid dependence receiving methadone maintenance treatment (Wen, 2021). A total of 20 RCTs (N=1997) evaluating patients with opioid dependence, as diagnosed by the Chinese Classification of Mental Disorders second or third editions or Diagnostic and Statistical Manual of Mental Disorders third or fourth editions, compared methadone maintenance treatment, traditional Chinese medicine (Chinese formulated herbal products), or 4 types of acupuncture (manual acupuncture, electroacupuncture, auricular acupuncture, and transcutaneous electrical acupoint stimulation [TEAS]). Heroin was the most commonly abused opioid across all trials. Treatment duration ranged from 7 to 90 days. A total of 14 studies that covered 8 head-to-head comparisons reported the recovery rate, which was assessed by the proportion of participants who were completely detoxified, nearly detoxified, or partially detoxified from therapy, indicated by varying levels of withdrawal. In the pair-wise meta-analysis, no statistically significant differences were observed in terms of recovery rate between methadone maintenance therapy and the various types of acupuncture. Withdrawal symptom scores measured by the Modified Himmelsbach Opiate Withdrawal Scale (MHOWS) were measured by 9 studies that included 8 direct comparisons of 5 interventions. A significant decrease in MHOWS score was observed with manual acupuncture compared to methadone maintenance therapy (-8.59; 95% CI, -15.96 to -1.23; p<.01). A network meta-analysis was also conducted to rank interventions for opioid dependence. In the comparisons for recovery rate, manual acupuncture was the most efficacious intervention for opioid dependence and methadone maintenance therapy was the least efficacious among all interventions; a statistically significant difference was only observed in manual acupuncture versus maintenance methadone therapy (risk ratio, 0.72; 95% CI, 0.50 to 0.95). In terms of withdrawal scores, manual acupuncture demonstrated a significant decrease in MHOWS scores compared to methadone therapy (-5.74; 95% CI, -11.60 to -0.10). While authors concluded that acupuncture may be effective for treating patients receiving methadone maintenance therapy, there were many limitations. All selected trials were conducted in China and no trials were at low risk of bias. Additionally, methadone maintenance therapy, including doses and frequency, were not well described.
The Department of Veterans Affairs/Department of Defense guideline on the treatment of low back pain suggests offering acupuncture to patients with chronic low back pain VA/DoD, 2022). The authors state: "Acupuncture appears to have a small benefit for the reduction of pain for those with chronic LBP [low back pain] in the intermediate-term (3 to 12 months). The evidence from two SRs [systematic reviews] and one small RCT [randomized controlled trial] favored acupuncture over sham for the critical outcome of pain intensity." For acute low back pain, there was insufficient evidence to recommend for or against the use of acupuncture
The Society for Integrative Oncology and the American Society of Clinical Oncology (ASCO) released joint guidance in 2022 on integrative approaches to managing pain in adults with cancer (Mao, 2022). The recommendations provided related to acupuncture are below:
2023 Update
Annual policy review completed with a literature search using the MEDLINE database through November 2023. No new literature was identified that would prompt a change in the coverage statement. The key identified literature is summarized below.
Pei et al published a systematic review and meta-analysis of 9 RCTs (N=582) evaluating acupuncture or electroacupuncture in patients with chemotherapy-induced peripheral neuropathy (CIPN) (Pei, 2023). Comparators included pharmacotherapy, sham, or no treatment. Pain outcomes were a secondary outcome. Heterogeneity was high, thus, the majority of outcomes were summarized with qualitative analysis. However, meta-analysis of 4 studies (n=260) was performed comparing vitamin B to acupuncture for sensory neuropathy finding improved outcomes with acupuncture versus vitamin B (risk ratio, 1.60; 95% CI, 1.31 to 1.95; I2=0%). Current RCTs are of low methodologic quality and higher quality trials are necessary to draw conclusions regarding the efficacy of acupuncture for CIPN.
Wu et al reported a 2x2 factorial, double-blind, RCT conducted at 13 centers in China (Wu, 2023). The trial enrolled 352 women in early pregnancy with moderate to severe nausea and vomiting. Patients were randomized to receive active or sham acupuncture and doxylamine-pyridoxine or placebo for 14 days. All active treatments had greater improvement on the Pregnancy-Unique Quantification of Emesis (PUQE) score at day 15 than control with mean differences of -0.7 (95% CI, -1.3 to -0.1) for acupuncture, -1.0 (95% CI, -1.6 to -0.4) for doxylamine-pyridoxine, and -1.6 (95% CI, -2.2 to -0.9) for the combination. Although both acupuncture and doxylamine-pyridoxine were significantly more effective than placebo, the clinical importance of this effect is questionable.
A more recent systematic review by Yan et al identified 38 RCTs (N=2503) evaluating acupuncture for prevention of chemotherapy-induced nausea and vomiting (Yan, 2023). All trials compared acupuncture with sham acupuncture or usual care. In comparison to usual care, acupuncture plus usual care did not significantly reduce acute nausea but did reduce acute vomiting (risk ratio, 2.20; 95% CI, 0.66 to 7.33 and risk ratio, 1.13; 95% CI, 1.02 to 1.25, respectively). There were no significant differences between acupuncture and sham in terms of acute nausea (risk ratio, 0.87; 95% CI, 0.26 to 2.90) or vomiting (risk ratio, 1.05; 95% CI, 0.72 to 1.53) when both interventions were added to usual care. Overall, the evidence was of low certainty and higher quality RCTs with large sample sizes are needed.
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| References: |
Bahrami-Taghanaki H, Azizi H, Hasanabadi H, et al.(2020) Acupuncture for Carpal Tunnel Syndrome: A Randomized Controlled Trial Studying Changes in Clinical Symptoms and Electrodiagnostic Tests. Altern Ther Health Med. Mar 2020; 26(2): 10-16. PMID 31634868 Boldt I, Eriks-Hoogland I, Brinkhof MW, et al.(2014) Non-pharmacological interventions for chronic pain in people with spinal cord injury. Cochrane Database Syst Rev. Nov 28 2014; (11): CD009177. PMID 25432061 Casimiro L, Barnsley L, Brosseau L, et al.(2005) Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. Oct 19 2005; (4): CD003788. PMID 16235342 Center for Medicare and Medicaid Services (CMS).(2003) Decision Memo for ACUPUNCTURE for Fibromyalgia (CAG- 00174N). 2003; https://www.cms.gov/medicare-coverage-database/details/technology-assessments-details.aspx? Center for Medicare and Medicaid Services (CMS).(2020) National Coverage Determination (NCD) for Acupuncture for Fibromyalgia (30.3.1). https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=283&ncdver=2&bc=AAAAIAAAAAAA&. Accessed November 2, 2020 Center for Medicare and Medicaid Services (CMS).(2020) National Coverage Determination (NCD) for Acupuncture for Osteoarthritis (30.3.2). https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=284&ncdver=2&bc=AAAAIAAAAAAA&. Accessed November 3, 2020. Choi GH, Wieland LS, Lee H, et al.(2018) Acupuncture and related interventions for the treatment of symptoms associated with carpal tunnel syndrome. Cochrane Database Syst Rev. Dec 02 2018; 12: CD011215. PMID 30521680 Chou R, Deyo R, Friedly J, et al.(2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. Apr 04 2017; 166(7): 493-505. PMID 28192793 Department of Veterans Affairs/Department of Defense (VA/DoD).(2022) VA/DoD clinical practice guideline for diagnosis and treatment of low back pain. 2022; https://www.healthquality.va.gov/guidelines/pain/lbp/. Accessed October 3, 2022. Department of Veterans Affairs/Department of Defense.(2017) VA/DoD clinical practice guideline for diagnosis and treatment of low back pain. 2017; https://www.healthquality.va.gov/guidelines/Pain/lbp/VADoDLBPCPG092917.pdf. Accessed November 2, 2020. Department of Veterans Affairs/Department of Defense.(2020) . VA/DoD clinical practice guideline for the non-surgical management of hip & knee osteoarthritis. . 2020; https://www.healthquality.va.gov/guidelines/CD/OA/VADoDOACPG.pdf. Accessed November 3, 2020. Department of Veterans Affairs/Department of Defense.(2020) VA/DoD clinical practice guideline for the primary care management of headache. 2020; https://www.healthquality.va.gov/guidelines/pain/headache/VADoDHeadacheCPGFinal508.pdf. Accessed November 4, 2020 Eccleston C, Fisher E, Thomas KH, et al.(2017) Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. Cochrane Database Syst Rev. Nov 13 2017; 11: CD010323. PMID 29130474 Giovanardi CM, Cinquini M, Aguggia M, et al.(2020) Acupuncture vs. Pharmacological Prophylaxis of Migraine: A Systematic Review of Randomized Controlled Trials. Front Neurol. 2020; 11: 576272. PMID 33391147 Green S, Buchbinder R, Barnsley L, et al.(2002) Acupuncture for lateral elbow pain. Cochrane Database Syst Rev. 2002; (1): CD003527. PMID 11869671 Green S, Buchbinder R, Hetrick S.(2005) Acupuncture for shoulder pain. Cochrane Database Syst Rev. Apr 18 2005; (2): CD005319. PMID 15846753 Haake M, Hans-Helge M, et al.(2007) German Acupuncture Trials (GERAC) for chronic low back pain. Arch Intern Med, 2007; 167:1892-8. He Y, Guo X, May BH, et al.(2020) Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncol. Feb 01 2020; 6(2): 271-278. PMID 31855257 Huang JF, Zheng XQ, Chen D, et al.(2021) Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis. Global Spine J. Oct 2021; 11(8): 1248-1265. PMID 33034233 Kolasinski SL, Neogi T, Hochberg MC, et al.(2020) 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). Feb 2020; 72(2): 149-162. PMID 31908149 Kolokotsios S, Stamouli A, Koukoulithras I, et al.(2021) The Effectiveness of Acupuncture on Headache Intensity and Frequency in Patients With Tension-Type Headache: A Systematic Review and Meta-Analysis. Cureus. Apr 01 2021; 13(4): e14237. PMID 33948422 Lam M, Galvin R, Curry P.(2013) Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). Nov 15 2013; 38(24): 2124-38. PMID 24026151 Li QW, Yu MW, Wang XM, et al.(2020) Efficacy of acupuncture in the prevention and treatment of chemotherapy-induced nausea and vomiting in patients with advanced cancer: a multi-center, single-blind, randomized, sham-controlled clinical research. Chin Med. 2020; 15: 57. PMID 32514290 Manheimer E, Cheng K, Wieland LS, et al.(2018) Acupuncture for hip osteoarthritis. Cochrane Database Syst Rev. May 05 2018; 5: CD013010. PMID 29729027 Mao JJ, Ismaila N, Bao T, et al.(2022) Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol. Sep 19 2022: JCO2201357. PMID 36122322 Mu J, Furlan AD, Lam WY, et al.(2020) Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. Dec 11 2020; 12: CD013814. PMID 33306198 North American Spine Society.(2020) Diagnosis and Treatment of Low Back Pain. 2020; https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf. Accessed November 2, 2020. O'Connor D, Marshall S, Massy-Westropp N.(2003) Non-surgical treatment (other than steroid injection) for carpal tunnel syndrome. Cochrane Database Syst Rev. 2003; (1): CD003219. PMID 12535461 Paley CA, Johnson MI, Tashani OA, et al.(2015) Acupuncture for cancer pain in adults. Cochrane Database Syst Rev. Oct 15 2015; (10): CD007753. PMID 26468973 Qaseem A, Wilt TJ, McLean RM, et al.(2017) Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. Apr 04 2017; 166(7): 514-530. PMID 28192789 Wen H, Chen R, Zhang P, et al.(2021) Acupuncture for Opioid Dependence Patients Receiving Methadone Maintenance Treatment: A Network Meta-Analysis. Front Psychiatry. 2021; 12: 767613. PMID 34966304 Zheng XZ, Xiong QJ, Liu D, et al.(2021) Effectiveness of Acupuncture Therapy on Postoperative Nausea and Vomiting After Gynecologic Surgery: A Meta-Analysis and Systematic Review. J Perianesth Nurs. Oct 2021; 36(5): 564-572. PMID 34404603 Zhu X, Hamilton KD, McNicol ED.(2011) Acupuncture for pain in endometriosis. Cochrane Database Syst Rev. Sep 07 2011; (9): CD007864. PMID 21901713 |
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Group specific policy will supersede this policy when applicable. This policy does not apply to the Wal-Mart Associates Group Health Plan participants or to the Tyson Group Health Plan participants.
CPT Codes Copyright © 2024 American Medical Association. |
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