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

One thought on “Acupuncture Medical Necessity and Documentation

Leave a Reply