Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain
July 17th, 2019 - Wyn Staheli, Director of Research
On July 15, 2019, CMS released a decision memo regarding a national coverage analysis for Acupuncture for Chronic Low Back Pain. CMS intends to cover acupuncture for CMS beneficiaries who are experiencing chronic low back pain. Coverage only extends to patients who are enrolled in a clinical trial sponsored by the National Institutes of Health (NIH) or a CMS-approved study. These clinical trials are in response to the opioid crisis.
HHS Secretary Alex Azar stated, “Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to treat the very real problem of chronic pain, and this proposal would provide patients with new options while expanding our scientific understanding of alternative approaches to pain.”
To further sweeten the deal for healthcare providers, according to the CMS press release,
“The NIH recently issued a Funding Opportunity Announcement for interested parties to apply to conduct an efficient, large-scale pragmatic trial to evaluate the impact of, and strategies to best implement, acupuncture treatment of older adults (65 years and older) with chronic low back pain. The announcement can be found here: https://grants.nih.gov/grants/guide/rfa-files/RFA-AT-19-005.html.”
The official comment page states that they are seeking the following (emphasis added):
“… comments that include scientific evidence and discuss appropriate clinicians and training requirements to provide acupuncture that improves health outcomes. In addition, for commenters recommending Coverage with Evidence Development, we are interested in comments related to appropriate outcomes and study designs.”
This is an excellent opportunity to help establish the efficacy of acupuncture. Comments are being accepted through August 14, 2019. Please keep in mind that comments should be limited to acupuncture for the treatment of chronic LBP only at this time.
There is only a limited time available to comment so we strongly encourage all interested parties to help CMS with their coverage determinations. We feel that there are many chiropractic and other professional organizations which could help create good study designs.
###
Questions, comments?
If you have questions or comments about this article please contact us. Comments that provide additional related information may be added here by our Editors.
Latest articles: (any category)
Artificial Intelligence in Healthcare - A Medical Coder's PerspectiveDecember 26th, 2023 - Aimee WilcoxWe constantly hear how AI is creeping into every aspect of healthcare but what does that mean for medical coders and how can we better understand the language used in the codeset? Will AI take my place or will I learn with it and become an integral part of the process that uses AI to enhance my abilities?
Specialization: Your Advantage as a Medical Coding ContractorDecember 22nd, 2023 - Find-A-CodeMedical coding contractors offer a valuable service to healthcare providers who would rather outsource coding and billing rather than handling things in-house. Some contractors are better than others, but there is one thing they all have in common: the need to present some sort of value proposition in order to land new clients. As a contractor, your value proposition is the advantage you offer. And that advantage is specialization.
ICD-10-CM Coding of Chronic Obstructive Pulmonary Disease (COPD)December 19th, 2023 - Aimee WilcoxChronic respiratory disease is on the top 10 chronic disease list published by the National Institutes of Health (NIH). Although it is a chronic condition, it may be stable for some time and then suddenly become exacerbated and even impacted by another acute respiratory illness, such as bronchitis, RSV, or COVID-19. Understanding the nuances associated with the condition and how to properly assign ICD-10-CM codes is beneficial.
Changes to COVID-19 Vaccines Strike AgainDecember 12th, 2023 - Aimee WilcoxAccording to the FDA, CDC, and other alphabet soup entities, the old COVID-19 vaccines are no longer able to treat the variants experienced today so new vaccines have been given the emergency use authorization to take the place of the old vaccines. No sooner was the updated 2024 CPT codebook published when 50 of the codes in it were deleted, some of which were being newly added for 2024.
Updated ICD-10-CM Codes for AppendicitisNovember 14th, 2023 - Aimee WilcoxWith approximately 250,000 cases of acute appendicitis diagnosed annually in the United States, coding updates were made to ensure high-specificity coding could be achieved when reporting these diagnoses. While appendicitis almost equally affects both men and women, the type of appendicitis varies, as dose the risk of infection, sepsis, and perforation.
COVID Vaccine Coding Changes as of November 1, 2023October 26th, 2023 - Wyn StaheliCOVID vaccine changes due to the end of the PHE as of November 1, 2023 are addressed in this article.
Medicare Guidance Changes for E/M ServicesOctober 11th, 2023 - Wyn Staheli2023 brought quite a few changes to Evaluation and management (E/M) services. The significant revisions as noted in the CPT codebook were welcome changes to bring other E/M services more in line with the changes that took place with Office or Other Outpatient Services a few years ago. As part of CMS’ Medicare Learning Network, the “Evaluation and Management Services Guide” publication was finally updated as of August 2023 to include the changes that took place in 2023. If you take a look at the new publication (see references below),....
