Idiopathic Scoliosis

Aetna covers spinal fusion with instrumentation and bone grafting for idiopathic scoliosis when the curve is ≥40° in adolescents <18 or ≥50° in young adults 18–25; growing-rod techniques (including the MAGEC system) are covered if surgical criteria are met, and orthoses/prostheses are covered when prescribed by a qualified provider and will significantly restore mobility‑related activities of daily living. Surface electrical muscle stimulators, non‑MAGEC expandable magnetic growing rods (e.g., Phenix), the Copes scoliosis brace, manual therapy, and any scoliosis surgery that does not meet the above criteria are considered experimental/investigational and not covered.

"Aetna considers the following types of braces and casts medically necessary durable medical equipment (DME) for the treatment of scoliosis: Standard thoracolumbosacral orthosis (TLSO)."

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