Transcription of Local Coverage Determination for Paravertebral …
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Local Coverage Determination for Paravertebral …
Local Coverage Determination (LCD) for ParavertebralFacet joint Blocks (L29252)Contractor InformationContractor NameFirst Coast Service Options, Number09102 Contractor TypeMAC - Part BBack to TopLCD InformationDocument InformationLCD ID NumberL29252 LCD TitleParavertebral facet joint BlocksContractor's Determination Number64490 AMA CPT/ADA CDT Copyright StatementCPT codes, descriptions and other data onlyare copyright 2011 American MedicalAssociation (or such other date of publicationof CPT). All Rights Reserved. ApplicableFARS/DFARS Clauses Apply. Current DentalTerminology, (CDT) (including procedurecodes, nomenclature, descriptors and otherdata contained therein) is copyright by theAmerican Dental Association. 2002, 2004 American Dental Association. All rightsreserved. Applicable FARS/DFARS Geographic JurisdictionFloridaOversight RegionRegion IVOriginal Determination Effective DateFor services performed on or after 02/02/2009 Original Determination Ending DateRevision Effective DateFor services performed on or after 10/04/2011 Revision Ending DateCMS National Coverage PolicyN/A Indications and Limitations of Coverage and/or Medical NecessityMedicare wil
· There is no associated neurological deficit and the pain is aggravated by hyperextension, rotation or lateral bending of the spine, depending on the orientation of the facet joint at that
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