More Back Pain Patients Using  Insurance for Acupuncture
Billing / Fees / Insurance

More Back Pain Patients Using Insurance for Acupuncture

Editorial Staff  |  DIGITAL EXCLUSIVE
WHAT YOU NEED TO KNOW
  • According to a study published in JAMA Network Open, the percentage of adult low back pain (LBP) patients with one or more insurance claims filed for acupuncture increased from 0.9% as of 2010 to 1.6% as of 2019.
  • Average number of annual visits for acupuncture also increased, from 7.6 visits to 8.2 visits - a statistically significant increase.
  • Low back pain claims were determined as the use of ICD-9 code 724.2 for all claims through 2015; and ICD-10 code M54.5 from 2015 onward. Acupuncture claims were determined as the use of CPT codes 97810 and 97811; as well as 97813 / 97814 for electroacupuncture.

While lack of insurance for acupuncture services remains a significant barrier to care, new findings suggest there is cause for optimism. According to a study published in JAMA Network Open,1 the percentage of adult low back pain (LBP) patients with one or more insurance claims filed for acupuncture increased from 0.9% as of 2010 to 1.6% as of 2019.

Average number of annual visits for acupuncture also increased, from 7.6 visits to 8.2 visits. While this may seem like a small increase, it was still deemed statistically significant by the study authors.

Findings were derived from analysis of “Optum’s de-identified Clinformatics DataMart Database, which includes patients with Medicare Advantage and commercial insurance, including employer-sponsored coverage, and contains insurance claims for every reimbursed office visit, procedure, and prescription fill.”

Low back pain claims were determined as the use of ICD-9 code 724.2 for all claims through 2015; and ICD-10 code M54.5 from 2015 onward. Acupuncture claims were determined as the use of CPT codes 97810 and 97811; as well as 97813 / 97814 for electroacupuncture. “Overall, 106 485 patients with LBP (1.6%) had 1 or more acupuncture claim, while 61 503 (0.9%) had 1 or more electroacupuncture claim; 29 217 patients (0.4%) had both an acupuncture and electroacupuncture claim.”

This study is published in an open-access journal; for free full-text access, click here.

Reference

  1. Candon M, Nielson A, Dusek A, et al. Utilization of reimbursed acupuncture therapy for low back pain. JAMA Netw Open, 2024;7(8):e2430906.
December 2024
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