This Clinical Policy Bulletin addresses invasive procedures for headaches. Aetna considers the following interventions experimental, investigational, or unproven for the following headache …

Acute phase treatment of neck pain in the physical therapy outpatient setting includes moist heat, gentle massage and temporary immobilization with a cervical collar that holds the neck in …

Minimally invasive/endoscopic cervical laminoforaminotomy for cervical radiculopathy/lateral and foraminal cervical disc herniations or other indications; Minimally invasive lumbar …

Disc nucleoplasty (also known as percutaneous radiofrequency thermo-modulation, percutaneous plasma discectomy or plasma disc decompression [PDD]) is a minimally invasive procedure to …

There are several cervical traction devices including the Gardner-Wells tongs and halter traction device. All the available devices require insertion of pins into the calvarial periosteum which is …

Our Clinical Policy Bulletins (CPBs) explain the medical, dental and pharmacy services we may or may not cover. They are based on objective, credible sources, such as the scientific literature, …

Radiofrequency (RF) treatment is a minimally invasive procedure that has been used for over three decades in treating various chronic pain syndromes such as trigeminal neuralgia, post …

Aetna considers the following medically necessary: Cervical laminectomy (and/or an anterior and/or back cervical discectomy and fusion) or uterine laminoplasty for people with herniated …

If no NCD or LCD is available, we’ll use the Aetna Clinical Policy Bulletins (CPB) referenced below to make the coverage determination.

1/10/24, 1:07 PM Back Pain - Invasive Procedures - Medical Clinical Policy Bulletins | Aetna https://www.aetna.com/cpb/medical/data/1_99/0016.html 5/466. criteria: a. Member has …