1999- Member N.I.H. Review Committee on Complementary Medicine
2001- Member N.I.H. Review Committee on Complementary Medicine
The 1997 N.I.H. consensus development conference on ‘Acupuncture’ offered it’s resulting key definition as:
“Acupuncture describes a family of procedures involving the stimulation of anatomical locations on the skin by a variety of techniques. There are a variety of approaches to diagnosis and treatment in American Acupuncture which incorporates medical traditions from China, Japan, Korea, and other countries.”
Modalities affecting the acupuncture points, the channels/meridians and the organs have always been a varied group of biophysical therapies, which include but have never been limited to the use of acupuncture needles.
The many systems of diagnostic perspectives and those of treatment are based upon the philosophical beliefs, theories and understanding of the human being, the internal organs and their inter-relationships and their relationships to the environment.
Acupuncture needles and moxibustion are but only two types of therapies, which have an effect on the Acupuncture points, channels/meridians and organs. In the reality of ‘Acupuncture’ there are many other non-needle bodywork modalities that for many maladies, illness and injury are superior to the use of acupuncture needles and/or moxibustion and cannot be separated from the overall concept of ‘Acupuncture’ in it’s fullest of meanings.
Medical acupuncturists define acupuncture as:
“Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning. This is done by inserting needles and applying heat or electrical stimulation at very precise acupuncture points
The World Health Organization recommends that Medical Doctors receive training in acupuncture equal to the basics taught to the non-MD acupuncturist, which is a minimum of 1,500 hours of didactic and clinical training and successfully passing a national standard test. Medical acupuncturists education varies from state to state with most having less than 300 hours of training and some having no formal training.
Non-MD licensed acupuncturists must pass a national standardized test given by the National Certification Commission of Acupuncture and Oriental Medicine (NCCAOM). Prior to sitting for the NCCAOM exam all applicants must successfully complete a minimum training of 1,725 hours, which consists of ‘Acupuncture’ theories and practices.
The licensed acupuncture profession is working towards the goal of increasing its educational standards to 4,000-hours of didactic & clinical hours. The degree title will be ‘Doctor of Acupuncture or Doctor of Oriental Medicine’ and will include additional allopathic modules in order to best integrate Acupuncture/Oriental medicine along side Western medicine. This would then be most similar to the best model seen in the world, in China. All practitioners are cross-trained and all graduates are Medical Doctors.
Medical Doctors have sufficient C.P.T. codes to choose from (8,000). The C.P.T. system was a great development by the American Medical Association but now there exists a lack of adequate coding for the majority of alternative healthcare practitioners. Licensed acupuncturists have only been assigned two C.P.T. codes since 1998. With the tremendous growth and demand for licensed acupuncturists many more codes are needed to cover all the biophysical modalities they administer. Acupuncture’s efficacy and cost effectiveness cannot be monitored, measured and/or evaluated unless there exists more codes which exist in the Alternative link, Inc. coding system.
Acupuncture is currently evaluated or has been evaluated for (1) lateral elbow pain, chronic asthma, smoking cessation, idiopathic headache and several other medical conditions without specific code.
ABC codes have been developed to remedy the lack of coding in many of the modalities used by the patient population. Due to the lack of coding for alternative medicine many patients have to pay out of pocket and some of these non-coded modalities may be positively effective in achieving faster and less expensive results in certain conditions or be effective in general. Additionally, some alternative modalities may not demonstrate efficiency or cost effectiveness and this information is unavailable due to the lack of codes. Adequate coding will further allow comparative studies between MD acupuncturists and licensed non-MD acupuncturists taking into account the differences in the quantity of their education.
Inadequate coding is unfair to the health system and to the taxpayers, as it does not allow accountable healthcare. The C.P.T. code system had revolutionized Medicine but now the gap needs to be filled. The ABC (2)codes fill that gap and allow a pragmatic approach to the needs of the insurers, the public health experts, the respective professions and the patient population.
Recently, surveys show that nearly 1 in 10 U.S. Adults has tried Acupuncture(2), and those amounts of money spent on acupuncture have not been evaluated as to cost effectiveness or benefit outcomes.
In the interests of public safety and cost savings, the additional coding standards of Alternative Link, Inc. should be implemented without delay.
Many federal programs already reimburse for ‘Acupuncture’ services with the small ‘a’ when administered by Medical Doctors (while these same programs deny payment to more highly qualified Acupuncturists) because the MDs are billing for services using conventional evaluation and management coding. Insurance carriers tend to discriminate against non-MD acupuncturists because of a lack of coding. We ask that NCVHS help solve these unfair practices by naming ABC code a national standard code set so that all properly trained acupuncturists can bill legally for their services. Without ABCcodes, the non-MD acupuncturists must use inappropriate CPT codes putting them at risk of fraud. We feel that this is not the intent of Congress when they passed the HIPAA legislation.
We would like to thank National Council of Vital Healthcare Statistics for their attention to this urgent public healthcare issue.
Acupuncture for lateral elbow pain
Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, Assendelft
W.
Acupuncture for chronic asthma
Linde K, Jobst K, Panton J
Acupuncture for smoking cessation
White AR, Rampes H, Ernst E
Acupuncture for idiopathic headache
Melchart D, Linde K, Fischer P, Berman B, White A, Vickers A, Allais G
(2) National Survey (NCCAOM) Acupuncture today Jan 2003 Volume 4, Number 1