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Is Your Client on Pins or Needles?
By George P. Surmaitis, Esq.

Acupuncture is entering into the mainstream. Rather than just an ancient remedy, there is increased scientific literature to support its effectiveness. It provides you with another tool to help your client deal with their injuries.

Alternative and Complementary Medicine are widely used in our society although not much is said. In fact, it is estimated that at least 1/3 of the population use alternative medicine, while less than 40% disclose this to even their health care providers. See Complementary and Alternative Medicine in the United States.

Other than acupuncture and chiropractic, most forms of alternative medicine and complementary medicine have no associated medical billing code and are not recognized by carriers. However, due to lobbying efforts by organizations representing chiropractors and acupuncturists, these non-traditional forms of treatment are offered limited recognition, and also regulated and subject to licensure requirements which establish accountability.[

Among these, acupuncture shows efficacy, is authorized as treatment, and offers another effective means for your client to find relief other than reliance upon medication alone. See MTUS, ยง9792.24.1(a)(1) [“Acupuncture” is used as an option when pain medication is reduced or not tolerated, it may be used as an adjunct to physical rehabilitation and/or surgical intervention to hasten functional recovery]. The MTUS guidelines suggest 3-6 acupuncture treatments and as noted is recommended when some alternative to pain medication is necessary.

In order to gain approval for acupuncture treatment a letter to the primary treating physician pointing out the MTUS guideline, requesting that if appropriate 3-6 initial treatments be requested (more can be requested later and is more likely to be approved if there is improvement with the first round), and you should include reference to research supporting acupuncture which the Primary Treating Physician can include in the request for authorization.

A good resource is the National Institutes of Health, National Center for Complementary and Alternative Medicine (NCCAM) which contains links to many studies.

In addition, some of the most current evidence based reviews include:

General: Springer Link

Pain: Acupuncture and Chronic Pain

Anxiety: Acupuncture for anxiety and anxiety disorders

You will run into requests for herbal medicines. However, this presents troubling issues of the purity of ingredients, the endless range of possible herbal medicine, the skill of the person dispensing herbal remedies, and the potential dangerous interaction with prescription medications such as Coumadin. For this reason clients should be questioned about all medications, including any herbal medicines in order to protect your client and yourself, with an understanding that that there is no current means for authorization for herbal remedies in general.

Acupuncture, however, is entering into the mainstream. Rather than just an ancient remedy, there is increased scientific literature to support its effectiveness. It provides you with another tool to help your client deal with their injuries.

George P. Surmaitis, Esq.
333 Gellert Boulevard, Suite 215
Daly City, CA 94015
(650) 994-1148
www.Workinjury-Disability.com

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