Dry Needling and Acupuncture

Something interesting and ultimately troubling is slowly occurring in the medical field.

Physical Therapists have adopted the technique of Acupuncture under a new name describing it in western medical terms. This wouldn’t inherently be a problem [borrowing techniques and modalities is commonplace] except that they are doing it with minimal additional training as well as fraudulently billing insurance for it. They describe it as a manual therapy and as such bill the insurance for a manual therapy. However, there are specific procedural codes for the insertion of needles without an injection and they and they are most certainly not manual therapy codes. Essentially, inserting needles without injection [acupuncture] has its own codes and by doing this technique but billing insurance for a manual therapy they are committing fraud on the system. According to the American Physical Therapy Asscociation there is no procedural code that specifically covers Dry Needling. They further state that unless told to do so by a specific third party payer [insurance company] they should not bill Dry Needling under the procedural code for manual therapy. Yet it is common practice. If Dry Needling is clearly under the scope of practice of a PT, why isn’t there a procedural code for it?

Worse still is that a patient’s insurance will often pay for the therapy performed by a Physical Therapist who has minimal training in the insertion of needles but will not pay if the same exact therapy is performed by an Acupuncturist who has extensive training and education is inserting dry needles.

My graduate level training in Acupuncture was 4 yrs worth of course work and clinical hours. I had to have over a thousand supervised treatments before even being able to sit for my board exams. Physical Therapists are taking a weekend course, 16 hours worth and being “certified” by these instructors to perform the insertion of needles, something which is expressly in Acupuncturists scope of practice, but not in Physical Therapists.

I believe the fact that PTs are actively marketing Dry Needling as something new and helpful is also fraudulent. Howerver, clearly they see clinical results and have seen evidence in studies that Acupuncture is effective. Thus they renamed it Dry Needling, described it using western terms like trigger point and intramuscular instead of Ashi [the Chinese term for a trigger point] an reaping huge financial benefits because they are already a part of the insurance bureaucracy and can get them to pay for it, albeit through a dishonest description and billing practice.

The FDA regulates filiform [thin] needles as Acupuncture needles. They do so because the sale of them to unqualified and untrained individuals is dangerous. Needles inserted incorrectly can and do cause damage and harm. Thus, PTs have created a new needle called a Dry Needle. However, this only happened because people kept pointing out that PTs were buying Acupuncture needles for “their” technique. No matter what these needles are called, they are regulate by the FDA as Acupuncture needles!

Clearly, inserting filiform needles [Acupuncture] into tender and overly tense areas in muscle and connective tissue is beneficial to the health of the body. Clearly musculoskeletal pain can be treated effectively with this therapy. There is good scientific evidence Acupuncture works….so much so Physical Therapists have adopted it as part of there practice. I wouldn’t mind, except, they can get paid by an insurance company to perform it, but I cannot. I’ve already had a patient say, I would have to pay you out of pocket, but my insurance covers it when my PT does Dry Needling.

If you have pain and muscle tension, you should decide. Do you want someone with thousands of hours of training, or someone with 16 hours of training performing minor surgery on you? [the act of inserting needles is considered minor surgery as it is invasive]

I know which I would choose. Please make sure whoever is performing this technique on you knows what they are doing and is well trained.

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This post was written by , posted on January 9, 2015 Friday at 10:35 am

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