CG-ANC-03 Acupuncture

This policy addresses coverage for acupuncture services. Acupuncture is medically necessary only for nausea/vomiting related to surgery, chemotherapy, or pregnancy; chronic knee or hip osteoarthritis significantly affecting daily activities; cancer pain; or tension headaches recurring for more than 12 weeks despite medication or behavioral therapy; it is not medically necessary for any other indication.

"The use of acupuncture is consideredmedically necessarywhen one or more of the following conditions is the target of therapy:"

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