Clinical Practice Guidelines
Clinical Quality and Clinical Practice Guidelines
In order to continue you must accept the following disclaimer:
ASH is committed to assisting providers in understanding Professionally Recognized Standards of Practice. The following Clinical Practice Guidelines have been developed through a review of currently available clinical information, including clinical outcome studies in the peer-reviewed published literature, regulatory status of the procedure, evidence-based guidelines of public health research agencies, evidenced-based guidelines, views of practitioners practicing in relevant clinical areas, and other relevant factors. American Specialty Health, Inc makes no representation and accepts no liability with respect to the content of any external information cited or relied upon in the Clinical Practice Guidelines. The description, background and positions reflected in the Clinical Practice Guidelines, including any reference to a specific provider, product, process or service by name or trademark, manufacturer, constitutes American Specialty Health, Inc opinion and are made without intent to defame. American Specialty Health, Inc makes no representation that these opinions are endorsed by any Healthcare Provider society or the American Chiropractic Association. American Specialty Health expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information including correction of any factual error.
The conclusion that a particular procedure is acceptable does not constitute a representation or warranty that this service is covered for a member's benefit plan. The member's benefit plan determines coverage.
ASH Clinical Practice Guidelines
- Techniques and Procedures Not Widely Supported As Evidence-Based
- Abscess Incision and Drainage
- Achilles Tendon Repair
- Acupuncture for Abdominal/Pelvic Pain
- Acupuncture for Smoking Cessation
- Acupuncture Point Injection Therapy (APIT)
- Acupuncture Services Medical Policy/Guideline
- Alcohol/Substance Abuse Screening and Intervention
- Alexander Technique
- Amputation of Distal Lower Extremities
- Ankle and Foot Arthrotomy
- Ankle Arthodesis
- Ankle Arthroplasty
- Ankle Arthroscopy
- Ankle/Foot Bone Cyst or Benign Tumor Treatment
- Ankle Foot Orthoses
- Ankle Ligament Repair
- Ankle Soft Tissue Biopsy for Suspected Cancerous Lesions
- Ashiatsu Oriental Bar Therapy
- Assistive Technology Assessment
- Athletic Training Medical Policy/Guideline
- Auditory Integration Therapy – Facilitated Communication
- Augmentative and Alternative Communication (AAC) and Speech Generating Devices (SGD)
- Autism Spectrum Disorder (ASD) - Outpatient Rehabilitation Services (Speech, Physical, and Occupational Therapy.)
- Axial/Spinal Decompression Therapy
- Behavioral Health Awareness
- Biofeedback
- Bone Cortex Incision of the Foot
- Bone Density Screening - Peripheral
- Bone Grafts (Autograph/Allograft) for Foot and Ankle Conditions
- Calcaneal Ostectomy
- Calcaneal Osteotomy
- Casting and Splinting
- Cervical Pillow and Cervical Supports
- Chiropractic Services Medical Policy / Guideline
- Chronic Pain Management: Resilience as a Clinical Tool
- Clinical Guidelines and Criteria
- Closed Treatment of Lower Extremity Fractures or Dislocations
- Cock Up Fifth Toe Correction
- Cognitive Rehabilitation
- CranioSacral Therapy (CST)
- Current Perception Threshold (CPG) - Sensory Nerve Conduction Threshold (sNCT)
- Debridement of Skin, Muscle and/or Fascia, or Bone in the Lower Extremities
- Deep Heating Modalities (Therapeutic Ultrasound and Diathermy)
- Developmental Delay Screening and Testing
- Diabetes/Glucose Screening Procedures
- Diabetic Shoe Inserts
- Direct Moxibustion - TERMED see Moxibustion (CPG 48)
- Direction and Supervision of Physical Therapy and Occupational Therapy Clinical Support Personnel
- Disease Screening Procedures
- Drop Table Assisted Manipulation
- Dry Needling
- Electric Stimulation for Pain, Swelling and Function in the Clinic Setting
- Electrodiagnostic Testing
- Evaluation and Management Services in a Nursing Facility or Rest Home - Podiatry
- Excision of Cutaneous Nerve Neuroma for the Ankle and Foot
- Exercise Therapy for Treatment of Non-Specific Low Back Pain
- Exercise Therapy for Treatment of Neck Pain
- Extra-Spinal Joint Manipulation/Mobilization for the Treatment of Lower Extremity Musculoskeletal Conditions
- Extra-Spinal Joint Manipulation/Mobilization for the Treatment of Upper Extremity Musculoskeletal Conditions
- Fall Prevention Program
- Feldenkrais Method
- First Toe Osteotomy
- First Toe Sesamoidectomy
- Foot Arthrodesis
- Foot/Toe Soft Tissue Tumor Excision
- Functional Leg Length Assessment
- Gastrocnemius Recession (e.g., Strayer Procedure)
- H-Wave® Electrical Stimulation
- Hair Mineral Analysis-Nutritional Management
- Hallux Rigidus Correction with Cheilectomy
- Hammertoe Surgical Repair
- Health and Behavior Assessments
- Heel Cord Lengthening or Shortening
- Home-Based Rehabilitation
- Home Traction Therapy
- Homeopathy
- Hyaluronan Injections
- Hypertension (High Blood Pressure) Management
- Hypnotherapy
- Incision and Drainage Below Fascia
- Informed Consent
- Injection Treatment for Morton's Neuroma
- Injury Prevention (Fall Risk Assessment in Elderly)
- In-Office Clinical Laboratory Services
- Inserts and Other Shoe Modifications for Individuals without Diabetes
- Instrument-assisted Soft Tissue Mobilization
- Intensive Model of Therapy
- Interdigital Excision and Nerve Implantation for Morton's Neuroma
- Intradermal Needles and Ear Tracks
- Intralesional Injections of the Ankle and Foot
- Intravenous Chelation Therapy
- Inversion Therapy
- Issuance of Referrals for Community Social and Support Services
- J Codes - Podiatry
- Joint and Soft Tissue Arthrocentesis, Aspiration, and Injection
- Knee Orthoses
- Laser Therapy (LT)
- Lipid Screening
- Logan Basic Technique
- Lower Extremity Tendon Lesion Excision
- Lower Extremity Tendon, Ligament, and Aponeurosis Injections
- Lower Extremity Tenolysis/Tenotomy
- Lower Extremity Trigger Point Injections
- Lymphedema
- Magnet Therapy - Static
- Management of Hallux Valgus (Bunions)
-
Managing Communications with Health Care Practitioners
- Managing Medical Emergencies
- Manipulation Under Anesthesia (MUA)
- Manual Muscle Testing and Range of Motion Testing
- Mechanical Traction (Provided in Clinic Setting)
- MEDEK Therapy
- Medical Necessity Decision Assist Guideline for Rehabilitative Care
- Medical Nutrition Therapy for Weight Management
-
Medical Nutrition Therapy – Medicare Advantage
-
Medical Nutrition Therapy and Dietetic Services - Medicare Advantage Supplement
- Medical Record Maintenance and Documentation Practices
- Metatarsal or Tarsal Nonunion/Malunion Repair
- Metatarsal Ostectomy
- Metatarsal Osteotomy
- Metatarsectomy
- Metatarsophalangeal and Interphalangeal Joint Capsulotomy
- Midfoot Osteotomy
- Moxibustion
- Nail Avulsion
- Nail Hematoma Evacuation
- Nail Unit Biopsy
- Nasium and Vertex X-Ray Views
- Nerve Block and Neurolytic Procedures for Foot Pain Excluding Morton's Neuroma
- Non-Invasive Interactive Neurostimulation (InterX®)
- Non-Invasive Vascular Studies
- Non-Motorized Flexion Distraction Technique
- Non-Vascular Extremity Ultrasound
- Obesity/Overweight
- Occupational Therapy Medical Policy/Guidelines
- Open Treatment of Ankle Fractures
- Open Treatment of Distal Tibialfibular Joint (Syndesmosis) Disruption
- Open Treatment of Tarsal, Talotarsal, Tarsometatarsal or Metatarsophalangeal Joint Dislocations
- Oral Sensorimotor Therapy and Myofunctional Therapy
- Orthotic Training and Evaluation
- Ostectomy for Tailor's Bunion
- Ostectomy for Tarsal Coalition
- Partial Excision of Foot or Ankle Bone
- Partial Excision of Tibia of Fibula Bone
- Passive Physiotherapy Modalities
- Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations for Dates of Service Prior to January 1, 2021
-
Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations for Dates of Service Effective January 1, 2021 - December 31, 2022
-
Patient Assessments: Medical Necessity Decision Assist Guideline for Evaluations and Re-evaluations for Dates of Service Effective January 1, 2023
- Pediatric Intensive Feeding Programs
- Percutaneous Fixation of Tarsometatarsal ,Metatarsophalangeal, and Interphalangeal Joint Dislocation with Manipulation
- Phototherapy (Ultraviolet Light and Actinotherapy)
- Physical Activity
- Physical Performance Testing or Measurement
- Physical Therapy Medical Policy/Guidelines
- Plantar Faseiectomy/Fascieotomy
- Practice Parameters and Review Criteria
- Preventive Care Services
- Preventive Medicine Assessments, Counseling and Special Services Performed by Doctors of Chiropractic
- Prolotherapy
- Prosthetic Training and Evaluation
- Psychosocial Factors in Pain Management
- Quality Patient Management
- Radical Resection and Biopsy of Malignant Tumors of the Foot or Toe
- Radiogaphic Quality and Safety Parameters
- Range of Motion Testing
- Reconstruction of Posterior Tibial Tendon
- Removal of Foot and Ankle Implants
- Removal of Soft Tissue Foreign Body from Foot or Toe
- Repair of Dislocating Peroneal (Fibularis) Tendons
- Repair of Rupture of Foot or Ankle Flexor or Extensor Tendons
- Repair or Reconstruction of Nail Bed
- Rigid Total Contact Leg Cast
- Rolfing
- Routine Foot Care (Commercial and Medicare Part B Benefits)
- Routine Foot Care (Medicare Advantage Supplement)
- Sacro Occipital Technique (SOT)
- Secondary Closure and Tissue Transfer to Surgical Wounds of the Lower Extremities
- Selected List of References - Medical Nutrition Therapy
- Self-Care/Home Management Training
- Sensory Integrative (SI) Therapy
- Soft Tissue Reconstruction of Angular Toe Deformity
- Speech-Language Pathology/Speech Therapy Guidelines
- Spinal Manipulative Therapy (SMT) for Musculoskeletal and Related Disorders
- Spinal Manipulative Therapy for Non-Musculoskeletal Conditions and Related Disorders
- Spinal Manipulative Therapy for Treatment of Children
- Spinal Ultrasound
- Strapping and Taping
- Stuttering Devices and Altered Auditory Feedback (AAF) Devices
- Superficial Heat and Cold
- Supports and Appliances
- Surgical Removal of Benign Lesions
- Syndactylization for Toe Deformities
- Tarsal Tunnel Decompression
- Telehealth Services
- Temporomandibular Joint Disorder
- Tendon Transfer or Transplant to the Foot
- Therapeutic Massage Medical Policy/Guideline
- Therapeutic, Prophylactic, or Diagnostic Injections
- Therapeutic Touch Therapy
- Thermography
- Thoracic and Lumbar Orthoses
- Thoracic Rib Belt
- Tobacco Cessation Counseling
- Treatment of Open Foot (Calcaneal, Tarsal, Talus, Metatarsal and Phalangeal) Fractures
- Ultrasound and Fluoroscopic (non-spinal) Guidance for Needle Placement and Fluoroscopy (separate procedure)
- Unna Boot
- Urgent/Emergent Services
- Upper Cervical Adjusting Techniques
- Upper Extremity Orthoses
- Vestibular Rehabilitation
- Virtual Physical Therapy and Rehabilitation Services
- Voice Therapy
- Webster Technique
- Wheelchair Management
- Wound Care
- X-Ray Guidelines
Other Useful ASH Policies
-
Evaluation of Medical Records
- Evidence Based Health Information Evaluation/Technology Assessment
- Evidence Selection and Evaluation
- Medical Necessity Definition
- Patient Safety - The Prevention, Recognition, and Management of Adverse Outcomes
-
Public Events: Providing Diagnostic and Treatment Services
- Public Events: Screenings and Health Fairs