E1665
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Key Coverage Criteria
- The use of acupuncture is consideredmedically necessarywhen one or more of the following conditions is the target of therapy:
- Nausea or vomiting associated with surgery, chemotherapy, pregnancy;or
- Chronic osteoarthritis of the knee or of the hip that is significantly affecting daily activity;or
- Cancer pain;or
- Tension headache recurring for more than 12 weeks despite medication or behavioral therapy (such as biofeedback or relaxation therapy);or
- Migraine recurring for more than 12 weeks despite medication treatment;or
1 Active Policy
ANTHEM-CG-ANC-03 — CG-ANC-03 Acupuncture
Related Codes
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