Monthly Archives: January 2015

Ask the Expert: How often and when should a re-examination be performed?

Re-exams as a general rule are done approximately every 30 days however there can be situations where an evaluation may be required sooner. These situations may include where there is a new injury, significant flare up or exacerbation, new and/or unrelated complaint, significant change in condition requiring a significant change in treatment plan, the patient’s condition becomes permanent and stationary and is ready for discharge, or per the providers discretion it is determined that it is medically necessary to provide services above and beyond the typical pre and post service evaluation associated with acupuncture services.

Acupuncture Medical Necessity and Documentation

To demonstrate the effectiveness and medical necessity of acupuncture providers should have documentation that indicates some or similar factors as listed below.

1. Reduction in the use of pain medication

2. “Functional improvement” clinically significant improvement in activities of daily living, ROM, functional performance tests et al as measured during the history and physical exam.

3. Use of standardized outcome assessment forms such as Oswestry, Neck Disability Index, and General Pain Index et al.

4. Physical examination where quantified findings demonstrate significant and measured changes.

5. Ultimately, of course, pain reduction demonstrates medical necessity but with pain reduction there is always increased function and that is the more significant change or outcome to be noted. If there is a decrease in pain without increase in function it is not considered significant