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Pain Management and Rehabilitation

Pain Management and Rehabilitation Page 1 of 10 UnitedHealthcare Medicare Advantage Coverage Summary Approved 09/21/2021 Proprietary Information of UnitedHealthcare. Copyright 2021 United HealthCare Services, Inc. UnitedHealthcare Medicare Advantage Cover a ge Summa r y Pain Management and Rehabilitation Policy Number: Approval Date: September 21, 2021 Instructions for Use Table of Contents Page Coverage Guidelines .. 1 Inpatient Pain Rehabilitation Programs .. 2 Outpatient Pain Rehabilitation Programs .. 2 Stimulators for Pain Management .. 2 Autogenous Epidural Blood 2 Decompression Procedure, Percutaneous, of Nucleus Pulposus (CPT code 62287) .. 2 Massage Therapy .. 2 Infusion Pumps for Treatment of Intractable Cancer Pain .. 2 Epidural Injections .. 2 Paravertebral Facet Joint/Nerve Blocks and Nerve Denervation .. 3 Trigger Point Injections.

Spine Procedures. Massage Therapy . ... Cervical and Thoracic Epidural Injections (CPT codes 62320, 62321, 64479 and 64480) ... Treatment of spasticity, acute post-operative care management. Medicare does not have a National Coverage Determination (NCD) for specific types of epidural injections listed above. ...

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  Post, Operative, Spine, Thoracic

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