Transcription of Facet Joint Injections for Spinal Pain – Commercial ...
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Facet Joint Injections for Spinal Pain – Commercial ...
Facet Joint and Medical Branch Block Injections for Spinal pain Page 1 of 11 UnitedHealthcare Commercial Medical Policy Effective 07/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Facet Joint and Medial Branch Block Injections for Spinal pain Policy Number: 2022T0004MM Effective Date: July 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale .. 1 Documentation Requirements .. 1 Definitions .. 2 Applicable Codes .. 3 Description of Services .. 4 Clinical 4 Food and Drug 8 References .. 8 Policy History/Revision Information .. 9 Instructions for 11 Coverage Rationale Diagnostic Facet Joint /Medial Branch Block Injections of the cervical, thoracic, and lumbar levels of the spine are proven and medically necessary in certain circumstances.
Conservative Therapy : Consists of an appropriate combination of medication (for example, NSAIDs, anagl esci s, etc.) in addition to physical therapy, spinal ma nipual tion therapy, cognitvi e behaviora ltherapy (CBT) or other interventions based on the individual’s specific presentatoi n, physica lfindni gs and imaging results.
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