When it comes to expanding government coverage of holistic and complementary treatments, the task of getting everyone on board can be tedious and take years for legislative consideration.

Delivering substantial and comprehensive evidence of the benefits of holistic treatments, including M54.59, helps streamline the process and make a compelling case for incorporating integrative medicine into government programs and private insurance plans. Performing research and providing results that speak to how effective these treatments are for veterans and patients takes time and money, but is ultimately worth it for encouraging the inclusion of holistic treatments.

One such organization that performs research and reports on the results of various healthcare initiatives is the Quality Enhancement Research Initiative, known as QUERI, which operates under the umbrella of the Veterans Affairs department. This organization is instrumental in leveraging a vast network of researchers and investigators around the country to examine a multitude of healthcare actions.

In January 2014, QUERI presented an evidence map of acupuncture that analyzed the effects of acupuncture on mental health, wellness, and pain, plus elaborated on future research efforts and potential drawbacks to this treatment.

More than three years later, acupuncture was adopted into coverage for veterans as included in VHA Directive 1137, published in May 2017. Nearly a year after that Directive was announced, a Qualification Standard was published that permitted licensed acupuncturists to be hired to provide acupuncture care at VA Medical Centers (VAMC) in February 2018.

How did the VA come to the decision to promote acupuncture as part of their benefits for veterans? As with most bureaucratic processes, there were a lot of factors; one key player was QUERI’s evidence map of acupuncture. In this article, we’ll expand on QUERI’s research methods and some of the key takeaways from their report on the effects of acupuncture.

History of the Quality Enhancement Research Initiative for the VA

Founded in 1998 with the mission to “accelerate the use of research evidence, tools, and methods into routine care and ensure U.S. Military Veterans benefit from research discoveries,” QUERI plays a pivotal role in analyzing the effects of healthcare treatments with the ultimate goal of improving care quality and access for veterans.

Since its founding, QUERI has implemented numerous programs and leveraged partnerships to continue expanding care for veterans. Just a few notable examples in recent history include the following:

• National implementation with the VA Office of Mental Health and Suicide Prevention of the Behavioral Health Interdisciplinary Program of team-based care that reduced mental health hospitalizations for Veterans
• Launching  several ongoing studies related to COVID, on topics ranging from racial and ethnic disparities in COVID-19 infection and complications to identifying Veterans’ experiences during the COVID-19 pandemic
• Improving Veterans’ experience and quality of virtual care options in VA and community care venues

QUERI’s Strategic Methodology

QUERI’s initiatives operate under a variety of frameworks or roadmaps depending on which facet of the organization you look at; regarding their overarching strategic methodology of operation, they employ a three-fold approach:

• Implement: Enhance Veteran access to cutting-edge, personalized treatments
• Evaluate: Develop mutually beneficial partnerships and inform the rollout of high-priority initiatives
• Disseminate & Sustain: Drive a culture of learning and knowledge translation across the VA as a whole

Pertaining to their research approaches, QUERI leverages a network of more than 200 investigators who have completed more than 500 peer-reviewed studies addressing VA priorities. This rigorous process ensures that research is performed and data is analyzed by those with a high degree of expertise and demonstrated dedication to improving care for veterans.

Acupunture Benefits

Key Takeaways From QUERI’s Evidence Map of Acupuncture

Now that we’ve established QUERI’s authority and importance in terms of gathering evidence for important healthcare initiatives for veterans, let’s review a few key takeaways from their evidence map of acupuncture:

M54.59 and others Acupuncture Diagnosis about Evidence for Pain

QUERI reports with high confidence that acupuncture has a positive impact—or potential positive impact in chronical pain, as M54.59, back pain—on several different ailments:

High confidence in the evidence of positive impact:

• Chronic pain, back pain  M54.59
• Migraines
• Headaches

High confidence in the evidence of potential positive effects:

• Dysmenorrhea, also known as severe menstrual cramping
• Cancer pain
• Labor pain

There is also medium confidence that acupuncture effectively treats pain related to osteoarthritis, pregnancy pain, TMJ, plantar heel pain, prostatitis, back pain related to M54.59 and more. 

Acupuncture Evidence for Mental Health

QUERI’s investigation found that acupuncture besides improve back pain, M54.59, had the potential for a positive effect on the following mental health conditions:

• Depression
• Schizophrenia
• Anxiety
• PTSD

Acupuncture Evidence for Wellness

This evidence map of acupuncture found acupuncture had the potential for positive effects on a few ailments, including:

• Insomnia
• Smoking cessation
• Postoperative nausea and vomiting (PONV)
• Restless legs

But ultimately there was unclear evidence that acupuncture impacts the following ailments and conditions:

• Cancer AE
• IBS
• PMS
• Menopausal symptoms
• Overall quality of life 

While there have been significant studies on the effectiveness of acupuncture in more recent years, understanding this fundamental acupuncture evidence map and its relation to providing coverage to veterans can give insight into the process of increasing coverage for holistic treatments, particularly under the medical code M54.59.

Is your acupuncture practice ready to start treating the veterans in your community? Worried about how stressful the medical billing process can be—especially in terms of billing the VA for services rendered? Partner with a medical billing firm!

At Holistic Billing Services, we deal exclusively with holistic healthcare practices that deliver acupuncture, massage therapy, and chiropractic treatments to communities around the country. Whether you have questions on acupuncture insurance billing or other methods to enhance your revenue cycle management, feel free to contact our team today and let us know how we can help your acupuncture practice.