00125
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Key Coverage Criteria
- Biofeedback therapy is consideredmedically necessarywhen the following criteria are met:
- Supervised by a physician or licensed practitioner;and
- Used as treatment for at least one of the following conditions:Cancer pain;orChronic back pain as part of a rehabilitation program;orChronic constipation;orFecal incontinence;orLevator ani syndrome, also known as anorectal pain syndrome;orMigraine or tension headaches;orUrinary incontinence.
- Cancer pain;or
- Chronic back pain as part of a rehabilitation program;or
- Chronic constipation;or
2 Active Policies
ANTHEM-SURG.00125 — SURG.00125 Radiofrequency and Pulsed Radiofrequency Treatment of Trigger Point Pain
ANTHEM-CG-MED-97 — CG-MED-97 Biofeedback and Neurofeedback
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.