Selective nerve root blocks

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Services that require precertification

www.ibxtpa.com

selective nerve root blocks • Paravertebral facet injection/nerve block/neurolysis • Regional sympathetic nerve block • Sacroiliac joint injections • Implanted spinal cord stimulators Services that require precertification Standard Precert Effective: 1/1/2019 This applies to elective, nonemergency services.

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Spinal Injections Coverage Decision

lni.wa.gov

Selective Nerve Root Blocks (SNRBs) SNRBs may be used when a worker has had 6 weeks of conservative care and still has radicular pain with positive imaging findings, but does not have the objective signs of motor, reflex or EMG changes. Use SNRBs only when: • The worker has clear sensory symptoms indicative of radiculopathy or nerve root

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Epidural Steroid Injections and Medial Branch Blocks

www.bwc.ohio.gov

(Selective Nerve Root Block SNRB) Table B: Crosswalk between level of spine and injection targets NOTE: An SNRB is a type of transforaminal epidural injection that physicians can use for diagnostic pur-poses in determining/verifying a particular spinal nerve root as a pain generator. The injection typically

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2020-2021 NIA Clinical Guidelines for Medical Necessity Review

www1.radmd.com

• Epidural steroid injections and or selective nerve root block; AND o Imaging studies confirm the presence of spinal cord or spinal nerve root compression (disc herniation or foraminal stenosis) at the level corresponding with the clinical findings (Bono, 2011). Imaging studies may include:

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Nerve Root Block versus Transforaminal Epidural?

www.radiology.wisc.edu

Selective Nerve Root Block: • Primarily a . diagnostic. procedure o Designed to determine if one particular nerve root is the cause of a patient’s symptoms o Can be a guide to whether further surgical intervention (e.g. foraminotomy, etc.) may benefit • Therapeutic benefit is …

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Minimally Invasive Spine Surgery Procedures and Trigger ...

static.cigna.com

intraosseous radiofrequency nerve ablation of basivertebral nerve (e.g., INTRACEPT® Intraosseous Nerve Ablation System) (CPT codes 64628, 64629, C9752, C9753) vertebral body tethering for adolescent idiopathic scoliosis (0656T, …

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