Aetna acupuncture dry needling Coverage Update

There is insufficient evidence of the efficacy of acupuncture as a treatment for fibromyalgia (AHRQ technology assessment, 2003).

Evidence supports acupuncture for migraine: randomized trials (eg, Vickers et al 2004; Allais et al 2003; Linde et al 2009) found clinically relevant benefits versus usual care or placebo in some studies.

Insufficient evidence exists for acupuncture for insomnia; further randomized trials are needed (Sok et al, 2003).

Some evidence supports acupuncture for hip and knee osteoarthritis, but benefits are small and may be due in part to placebo effects (Manheimer et al, 2010; Berman et al, 2004).

Acupuncture has demonstrated benefit for chronic low back pain in multiple studies and guidelines (eg, ACP 2017) recommend acupuncture as a nonpharmacologic option; however effects may be similar to other active therapies and often short-term.

Evidence regarding acupuncture and moxibustion for correction of breech presentation is inconsistent; systematic reviews (Coyle et al 2005) concluded insufficient evidence to recommend routine use.

Systematic reviews found no reliable evidence for acupuncture in xerostomia and insufficient evidence for irritable bowel syndrome and allergic rhinitis/asthma.

Acupuncture for Bell's palsy: Cochrane review (Chen et al 2010) found trials of inadequate quality to draw conclusions.

There is insufficient evidence to support acupuncture for respiratory symptoms and dyspnea palliation in cancer or advanced COPD (Ben-Aharon et al 2008; Bausewein et al 2008; Gibson et al 2010; Marciniuk et al 2011).

Limited or low-quality evidence exists across many other indications (examples below); most reviews cite small trials, heterogeneity, and methodological flaws that preclude firm conclusions:

- Dry eye: limited evidence with small trials showing improvements in some measures but overall low quality (Lee et al, 2011).

- Amblyopia (anisometropic): small randomized crossover trial reported adjunctive benefit but further study needed (Lam et al, 2011).

- Autism spectrum disorders: Cochrane review (Cheuk et al, 2011) found inadequate evidence; most trials poor quality and inconsistent.

- Chronic constipation: a large RCT reported benefit of electro-acupuncture versus sham for complete spontaneous bowel movements but longer-term data and blinding limitations remain (Liu et al, 2016).

- Cancer-related indications (fatigue, pain, lymphedema, hot flashes, sleep disturbance): systematic reviews/meta-analyses show mixed results with heterogeneity and limited-quality evidence; some trials suggest benefit for specific outcomes but overall conclusions call for more rigorous trials.

- Neuropathic pain: Cochrane review (Ju et al, 2017) found very low-quality evidence and insufficient data to support or refute acupuncture for neuropathic pain.

- Occipital neuralgia, oral ulcer, renal colic: recent meta-analyses report positive findings but are limited by small, heterogeneous, and often low-quality trials; higher-quality, multicenter RCTs are needed.

- Pediatric indications: systematic reviews found promising results for some conditions (eg, amblyopia, cerebral palsy, nocturnal enuresis) but overall many pediatric reviews were low quality and conclusions cautious (Yang et al, 2015).

- Numerous other indications (eg, Alzheimer’s disease, PTSD, alcohol withdrawal, osteoporosis, obstructive sleep apnea, diabetic gastroparesis, mild cognitive impairment, restless legs syndrome, plantar fasciitis, peptic ulcer, post-operative ileus, post-stroke shoulder pain, premature ejaculation, PMS/PMDD, sexual dysfunction, abdominal obesity, non-alcoholic fatty liver disease, osteoporotic fracture pain, Parkinson’s-related fatigue) have been evaluated in systematic reviews or RCTs with mixed or low-quality evidence; common themes are small sample sizes, heterogeneity of interventions, risk of bias, and need for larger rigorous trials.

Dry needling: evidence is mixed. Some RCTs suggest short-term pain reduction for myofascial trigger point syndromes (eg, Kietrys et al, 2013) but overall quality is low-to-moderate, longer-term benefits are uncertain, and professional organizations differ in their characterizations of dry needling versus acupuncture. Many reviewers conclude dry needling/dry needling-related trigger point injections lack consistent evidence as sole treatment for chronic non-malignant pain and should be considered investigational in many contexts.

Across conditions, methodological limitations (small trials, inadequate randomization or blinding, heterogeneous acupuncture techniques and comparators, subjective outcomes, publication bias, and predominance of single-country studies) limit confidence in effect estimates. High-quality, adequately powered, blinded (where feasible), multicenter RCTs with standardized interventions and clinically relevant objective outcomes are needed to clarify the effectiveness and safety of acupuncture and related techniques.

Provider Responsibilities, Prior Authorization, and Documentation

Prior Authorization

Verify plan-specific coverage

Standard Aetna plans may limit acupuncture coverage by provider type or setting. Providers must verify member plan benefits and any plan-specific restrictions before delivering or billing for acupuncture.

Check member benefit plan descriptions for: whether acupuncture is limited to physicians, whether coverage is only when used in lieu of anesthesia for surgical/dental procedures, and any other plan-specific restrictions.

Prior Authorization

Prior authorization for LBP-related acupuncture

Prior authorization may be required for acupuncture requested for low back pain (acute/subacute/chronic) in accordance with plan rules and to ensure appropriate sequencing with other nonpharmacologic therapies.

Document prior trial/failure of or contraindication to recommended first-line nonpharmacologic therapies when applicable (e.g., structured exercise, spinal manipulative therapy).
Reference ACP 2017 guidance recommending acupuncture among nonpharmacologic options for acute/subacute and chronic low back pain.
If no clinical benefit after an appropriate trial, include re-evaluation notes (see reevaluation after 4 weeks).

Prior Authorization

Adjunctive-use prior authorization

When acupuncture is requested as an adjunct to conventional therapies, prior authorization should require documentation that standard therapies have been tried or are being provided concurrently.

Attach documentation of prior or concurrent standard therapy (e.g., exercise program, NSAIDs, physical therapy, orthotics for plantar fasciitis).
For osteoarthritis, note acupuncture is adjunctive to standard care (medications, exercise).

Prior Authorization

Restrict certain indications to trials or require prior authorization

For indications with little or no evidence of benefit (e.g., infantile colic, breech presentation, many experimental uses), require either enrollment in a clinical trial or prior authorization with detailed justification.

Infantile colic: restrict acupuncture to clinical trials per Skjeie et al (2013).
Moxibustion for breech: insufficient evidence — require prior authorization and documentation of counseling and ECV attempts/contraindications.
Requests for experimental/limited-evidence indications must include trial protocol or literature support and a plan for objective outcome measurement.

Prior Authorization

Prior authorization for experimental/limited-evidence indications

Prior authorization is recommended for acupuncture requests for investigational or limited-evidence indications so that the plan can assess the evidence, intended outcomes, and safety monitoring before approval.

Provide supporting literature (RCTs, systematic reviews) when seeking coverage for investigational indications.
Include proposed outcome measures, number of sessions, and duration of therapy.
If the evidence is low-quality or inconsistent, expect case-by-case review or denial.

Note

Prior authorization not specified in background evidence

Background evidence sections do not specify which procedure or diagnosis codes require prior authorization. Providers should follow standard plan prior authorization procedures and check plan-specific requirements.

No specific CPT/HCPCS/ICD-10 codes are listed in background evidence as requiring prior authorization.
Verify prior authorization/code requirements via the payer portal or Clinical Policy Bulletins.

Prior Authorization

Prior authorization recommended for investigational indications (including dry needling)

Dry needling and many investigational indications are listed as experimental/investigational and prior authorization or denial may apply; documentation of training and licensure is required for any consideration.

Dry needling is listed among experimental/investigational procedures — generally not covered.
If considered, submit proof of practitioner licensure, credentialing, and invasive-procedure training.
Expect stricter review for invasive procedures due to safety risks.

Denial Risk

Dry needling: experimental / coverage limitation

Dry needling is considered experimental/not covered in many plan contexts; providers must submit credentialing information if requesting coverage for any dry needling services.

20560/20561 (needle insertion for 1-2 muscles or 3+ muscles) are listed but may be non-covered when billed for dry needling per policy experimental listing.
Attach documentation of medical necessity and practitioner qualifications if requesting exception review.

Documentation Required

Plan of care required to establish medical necessity

Acupuncture services must be provided under an ongoing, written plan of care that documents medical necessity, goals, frequency/duration, and progress; absence of this plan risks denial.

Required plan of care elements: diagnosis with onset/exacerbation date; specific short- and long-term quantitative goals; reasonable estimate of time to reach goals; acupuncture evaluation; frequency and duration of treatment; acupuncture protocol to be used.
Plan must be signed by attending physician and/or acupuncturist and updated as condition changes.
Lack of an ongoing written plan of care or failure to document measurable improvement are grounds for denial.

Note

Prior authorization: no specific codes listed in provided excerpt

The policy appendix and code section do not list specific prior authorization codes in the provided excerpt; providers must follow payer portals and Clinical Policy Bulletins for operational prior authorization and billing instructions.

No explicit prior authorization CPT/ICD codes provided in background: verify via Aetna prior authorization resources.
Clinical Policy Bulletins assist in administering plan benefits but are not guarantees of coverage.

Denial Risk

Lack of clinical improvement — reevaluate after 4 weeks

Maintenance acupuncture without documented clinical improvement is not medically necessary. If no meaningful benefit is seen after four weeks, reevaluate the treatment plan and consider discontinuation.

If no clinical benefit after 4 weeks, document reevaluation and rationale for continuation.
Maintenance treatment with neither regression nor improvement is considered not medically necessary and may be denied.

Prior Authorization

Breech presentation — limited evidence

Breech presentation and moxibustion: evidence is insufficient to support routine use. Prior authorization or trial enrollment and documentation of alternative management (e.g., ECV) should be provided.

Provide documentation of attempted or contraindicated ECV and counseling when requesting moxibustion for breech.
RCOG and Cochrane reviews conclude evidence is insufficient; expect scrutiny and possible restriction to trials.

Note

Evidence quality may affect coverage decisions

Evidence quality varies widely across indications. Low-quality, small, heterogeneous, or short-duration trials may lead to case-by-case review or coverage denial.

When requesting coverage for indications supported by low-quality evidence, include higher-quality supportive studies (RCTs, meta-analyses) when available.
Be aware that methodological flaws (randomization, blinding, allocation concealment) and reporting deficiencies reduce likelihood of approval.

Denial Risk

Low-quality evidence may risk denial

Low-quality or very-low-quality evidence for many indications (e.g., OSA, OVCF pain, neuropathic pain) increases the risk of denial or requirement for prior authorization with robust justification.

Provide GRADE or systematic review level evidence when available.
For neuropathic pain, evidence is limited and of very low quality — include detailed clinical rationale if requesting coverage.

Note

No explicit authorization or billing requirements in background evidence

Background sections generally summarize clinical trial results and do not define operational authorization or billing rules. Providers must use payer portals and CPBs for billing/prior authorization steps.

No explicit authorization or billing requirements are specified in the background; check Clinical Policy Bulletins and the payer prior authorization system.
When submitting claims, include supporting documentation cited in the medical record and plan of care.

Prior Authorization

Neuropathic pain — limited evidence

Neuropathic pain evidence is limited and inconsistent; prior authorization reviews should require clear documentation of prior therapies, symptom severity, and rationale for acupuncture as part of the treatment plan.

Include pain scores, prior medication trials, functional impact, and expected objective outcome measures.
Because studies are small and at high risk of bias, expect detailed case review and possible denial.

Denial Risk

Low-quality evidence may trigger noncoverage

When evidence is low-quality, plan-level reviewers may trigger noncoverage or require additional documentation; include high-quality study references and objective outcome measures to support requests.

Document comparator treatments tried, number of sessions, outcome measures used, and any adverse events.
If studies cited are heterogeneous or at high risk of bias, be prepared for denial or requests for more data.

Documentation Required

Provider training and licensure risk for dry needling

Due to the invasive nature and potential serious harms of dry needling, providers must document appropriate training, licensure, and credentialing when requesting coverage; inadequate documentation risks denial and patient safety concerns.

Include state licensure, institutional privileging, coursework in needling techniques, and complication-management training.
Demonstrate experience with invasive procedures and adherence to infection-control standards.

Documentation Required

Scope of practice / credentialing

Scope of practice and credentialing assertions: many professional organizations consider dry needling equivalent to acupuncture; plans may limit coverage to appropriately licensed and credentialed practitioners.

Verify that the practitioner is operating within state scope of practice and institutional credentials.
Plans may restrict coverage to legally qualified physicians or licensed acupuncturists depending on member's plan.

Documentation Required

Trial quality and reporting deficiencies — documentation expectations

Documentation deficiencies in trials (randomization, allocation concealment, blinding, sample-size calculations) are common. When requesting coverage based on trial-like interventions, include detailed trial comparators, outcome measures, duration, and adverse events.

Provide trial details: number of sessions, intervention specifics (EA vs manual), sham-control design, follow-up duration, and reported AEs.
Use validated outcome measures (e.g., VAS, ODI, DRSP, HIT, BCVA) where applicable.

Documentation Required

Documentation recommended for trials-like interventions

For adjunctive or trial-like interventions, document treatment frequency, acupoints/technique, number of sessions, comparator details, objective outcome measures, and adverse event monitoring to support medical necessity.

Specify acupuncture protocol (points, needle retention time, electrical stimulation if used), session count, and total duration.
List primary and secondary outcome measures and schedule for reassessment; report any adverse events.

Note

Supportive evidence references and required trial documentation

When citing trial evidence to support coverage, include comparator arms, validated outcome measures, and adverse event reporting; this strengthens the case during prior authorization or appeals.

Cite high-quality RCTs and meta-analyses (e.g., Vickers et al for headache/migraine, Manheimer/Furlan for LBP, Berman for OA) where relevant.
Attach study endpoints (e.g., headache days, VAS, ODI, BCVA) and how the requested care expects to achieve similar outcomes.

Documentation Required

Training / licensure documentation required

Document practitioner training, licensure, and credentials when billing for invasive needling procedures. Lack of these documentation items creates denial risk and safety concerns.

Include copies of licenses, certifications (e.g., NCCAOM), privileging letters, and procedure-specific training.
Ensure signatures on the plan of care from the attending physician and/or acupuncturist are present.

Documentation Required

Required plan of care elements

Required elements of the plan of care must be present and updated: diagnosis with onset date, specific quantitative goals, expected timeframe, acupuncture evaluation, frequency/duration, and the acupuncture protocol. Absence or insufficiency risks denial.

Short- and long-term goals must be measurable and objective; document progress toward goals at regular intervals.
Signature of attending physician and/or acupuncturist is required; plan must be ongoing and updated as condition changes.

Documentation Required

Provider responsibility and documentation context

Providers are responsible for ensuring medical advice, treatment rationale, and documentation meet plan requirements. Clinical Policy Bulletins guide administration but are not guarantees of coverage.

Clinical Policy Bulletins are tools to assist benefit administration; check plan documents for definitive coverage.
Maintain thorough medical record documentation to support medical necessity, prior authorization requests, and appeals.

Step Therapy

Sequence of nonpharmacologic LBP therapies

When nonpharmacologic LBP therapies are used, follow recommended sequencing: structured exercise or spinal manipulative therapy are preferred initial options; if no benefit after an appropriate trial (commonly 8 weeks), consider acupuncture with documentation and prior authorization.

If structured exercise or SMT tried for 8 weeks without benefit, document lack of response before initiating or authorizing acupuncture.
Include prior treatments, duration, and objective reassessment results in the authorization request.

Step Therapy

Prefer standard therapies first; document adjunctive use

Prefer standard evidence-based therapies before acupuncture for many conditions. When acupuncture is considered adjunctive, document prior or concurrent use of conventional therapies; consider step-therapy requirements for specific indications (e.g., plantar fasciitis).

For plantar fasciitis, consider requiring failure of conservative treatments (physical therapy, orthotics, NSAIDs) prior to approving acupuncture.
For conditions with established standard treatments (e.g., exercise for PCOS, ECV for breech), document those therapies and rationale for acupuncture adjunct use.

Note

Multidisciplinary / rehabilitation approach recommended

When acupuncture or trigger point interventions are used as part of care for myofascial pain, they should be integrated into a multidisciplinary rehabilitation approach rather than used in isolation.

Trigger point injections and dry needling are generally part of a broader rehab plan including physical therapy, education, medications as needed.
Repeated trigger point injections in the same muscle after 2-3 unsuccessful attempts are not recommended.

Definitions and Key Terms

inv-102: Acupuncture — definition

TermAcupuncture

DefinitionTherapeutic intervention based on stimulation of identifiable points close to the skin to correct imbalances of Qi; includes manual and electroacupuncture and is proposed to work via central and peripheral neurochemical changes (e.g., release of endogenous opioids and peptides).

Typical techniques includedManual acupuncture, electroacupuncture, scalp, auricular, fine-needle techniques, and related stimulations as described in trials.

inv-103: Dry needling — definition & coding

TermDry needling

DefinitionInsertion of filiform needles into myofascial trigger points (intramuscular needling) to inactivate trigger points and reduce pain; described in the policy as a technique distinct from traditional acupuncture and listed as experimental/investigational.

Associated CPT codesCPT 20560 (1–2 muscles) and 20561 (3 or more muscles) are referenced for dry needling in the policy.

inv-104: Moxibustion — definition

TermMoxibustion

DefinitionTraditional acupuncture-related technique involving burning an herbal preparation (commonly Artemisia vulgaris, 'moxa') near an acupoint (e.g., BL67 at the tip of the 5th toe) to provide heat stimulation.

Evidence summaryCochrane and guideline reviews conclude evidence from randomized trials is insufficient to support routine use for fetal breech presentation; recommendations are inconsistent across organizations.

inv-105: Moxibustion — breech presentation evidence

ContextUse for fetal breech presentation (e.g., moxibustion at BL67)

Evidence conclusionSystematic review concluded there is insufficient evidence from randomized controlled trials to support moxibustion to correct breech presentation; RCOG and Cochrane note need for well-designed RCTs.

Clinical implicationMay lead to noncoverage or requests for additional documentation when offered as alternative to established interventions such as ECV.

inv-106: Verum vs sham acupuncture (trial context)

Verum acupunctureNeedle insertion at standard acupuncture points with manipulation (e.g., achieving 'de qi') as used in clinical trials.

Sham acupunctureControl technique using superficial or non-acupoint needling without manipulation intended to blind participants in RCTs.

Trial relevanceVerum versus sham comparisons are commonly used to assess specific effects beyond non-specific/placebo effects in acupuncture trials.

inv-107: Acupuncture — procedural scope

Procedure descriptionInsertion of needles (including traditional manual, electroacupuncture, scalp, auricular, fine-needle, and related stimulations) at acupuncture points; may include electrical stimulation (EA) or warming techniques.

Common uses in trialsEvaluated for pain, nausea, functional disorders, and other indications across randomized trials and systematic reviews.

Related interventionsAcupoint injection, moxibustion, acupressure, and electro-acupuncture are described as related or adjunctive techniques in the literature.

inv-108: Acupuncture point injection (acupoint injection, biopuncture)

TermAcupuncture point injection (acupoint injection, biopuncture)

DefinitionInjection of small amounts of saline or other substances (e.g., herbal extracts, drugs, vitamins) into acupuncture points/trigger points; similar needle placement to acupuncture but includes substance injection.

Evidence stanceInsufficient evidence to support effectiveness; small RCTs and flawed designs limit conclusions.

inv-109: Electro-acupuncture (EA) — definition & example

TermElectro-acupuncture (EA)

DefinitionAcupuncture technique in which electrical stimulation is applied to acupuncture needles; used in trials such as for chronic severe functional constipation with specified session regimens.

Trial exampleLarge randomized sham-controlled trial of EA for chronic severe functional constipation used 28 sessions over 8 weeks (n=1,075) and reported increased complete spontaneous bowel movements versus sham.

inv-110: Electro-acupuncture (EA) — technique & evidence

TechniqueEA involves electrical stimulation applied to needles placed at traditional acupoints; parameters vary by trial.

Evidence summaryEvaluated in multiple RCTs and meta-analyses for indications such as constipation and OSA; trials report variable quality and heterogeneous protocols.

Clinical noteTherapeutic effects and reporting depend on session number, stimulation parameters, and follow-up duration described in trials.

inv-111: Sham acupuncture — definition

TermSham acupuncture

DefinitionControl technique using non-acupoints or superficial needling intended to blind participants; commonly used as comparator in RCTs and systematic reviews.

Trial implicationsMany trials report similar within-group improvements for verum and sham, highlighting potential non-specific/placebo effects and the importance of high-quality trial design.

inv-112: Warm needle acupuncture (WNA)

TermWarm needle acupuncture (WNA)

DefinitionForm of acupuncture commonly used in China that involves warming the needle during insertion; evaluated in trials for primary osteoporosis and reported possible increases in BMD but trials at high risk of bias.

Evidence noteMeta-analyses suggest potential benefit on BMD and pain but are limited by low-quality trials and poor safety reporting.

inv-113: AHI — definition

TermAHI (Apnea–Hypopnea Index)

DefinitionMeasure used to diagnose and categorize obstructive sleep apnea severity; used as a primary outcome in OSA acupuncture trials reporting reductions in AHI and ESS in some meta-analyses.

Trial relevanceUsed to quantify OSA severity changes in acupuncture/electroacupuncture RCTs and meta-analyses.

inv-114: IELT — definition

TermIELT (Intravaginal ejaculatory latency time)

DefinitionPrimary outcome measure used in studies of premature ejaculation; represents time to ejaculation as reported in trials and planned meta-analyses.

Research useFrequently used as primary efficacy endpoint in acupuncture trials for premature ejaculation.

inv-115: DRSP — definition

TermDRSP (Daily Record of Severity of Problems)

DefinitionValidated patient-reported scale used to assess mood and physical symptoms in PMS trials; used as an outcome in acupuncture studies for PMS/PMDD.

Evidence noteCochrane review of PMS/PMDD included trials using DRSP; evidence quality ranged low to very low.

inv-116: Dry needling — clinical definition

TermDry needling (clinical definition)

DefinitionInsertion of an acupuncture-like filiform needle into a myofascial trigger point aimed at reducing pain and restoring range of motion; may be performed using superficial or deep techniques and differs from trigger point injection by absence of injected fluid.

Practice implicationsPosition statements emphasize differences in training, technique, and scope of practice; professional organizations often equate it with acupuncture and recommend appropriate credentialing due to invasive nature and safety risks.

inv-117: Trigger point injection (wet needling)

TermTrigger point injection (wet needling)

DefinitionInjection of fluid (e.g., local anesthetic) directly into a myofascial trigger point to produce rapid pain relief and muscle relaxation; differs from dry needling by use of injectate.

Clinical useTypically part of a multidisciplinary rehabilitation approach; usually requires ~3 treatments to abolish a trigger point and rarely >5 points treated per session; repeated injections after 2–3 unsuccessful attempts are not recommended.

inv-118: Myofascial trigger point

TermMyofascial trigger point

DefinitionDiscrete focal tenderness (2–5 mm) within a taut band of skeletal muscle that elicits local and referred pain when palpated.

Treatment noteTrigger point needling or injection targets these focal points to reduce local and referred pain; evidence for chronic applications is inconsistent.

inv-119: Dry needling — alternate definition & evidence

TermDry needling (alternate phrasing)

DefinitionInsertion of an acupuncture-like needle into a myofascial trigger point with the goal of reducing pain and restoring range of motion; techniques and training vary across approaches.

Evidence summarySystematic reviews (e.g., Kietrys et al 2013) found immediate and 4-week pain reduction versus sham for upper-quarter MPS but noted limited high-quality trials and heterogeneity.

inv-120: Trigger point injection/needling

TermTrigger point injection/needling (general)

DefinitionNeedling or injecting myofascial trigger points; provides pain relief ranging from duration of anesthetic to months and typically requires about 3 treatments to abolish a trigger point; multiple trigger points (rarely >5) may be treated in one session.

Practice guidanceShould be short-term and part of comprehensive rehabilitation; repeated injections in same muscle are not recommended after 2–3 unsuccessful attempts.

97810	Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with patient.
97811	Acupuncture, without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure).
97813	Acupuncture, with electrical stimulation, initial 15 minutes of personal one-on-one contact with patient.
97814	Acupuncture, with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needle(s) (List separately in addition to code for primary procedure).

G43.001 - G43.919	Migraine
M54.2	Cervicalgia [chronic neck pain]
M54.50 - M54.59	Low back pain
O21.0 - O21.9	Excessive vomiting in pregnancy
R11.2	Nausea with vomiting [postoperative] [chemotherapy-induced]
M16.0 - M17.9	Osteoarthritis of hip and knee
M26.601 - M26.69	Temporomandibular joint disorders

B02.21 - B02.29	Zoster with other nervous system involvement
B18.0 - B18.1	Chronic (viral) hepatitis B
G30.0 - G30.9	Alzheimer's disease
G35	Multiple sclerosis
E66.01 - E66.9	Overweight and obesity

OpenPayer

Acupuncture and Dry Needling

Coverage Criteria and Evidence Summaries

Billing and Coding

Provider Responsibilities, Prior Authorization, and Documentation

Definitions and Key Terms

Background and Evidence Context

Policy Revision History

20560	Needle insertion(s) without injection(s); 1 or 2 muscle(s).
20561	Needle insertion(s) without injection(s); 3 or more muscles [dry needling].