RAD.00034 Dynamic Spinal Visualization (Including Digital Motion X-ray and Cineradiography/Videofluoroscopy)

This policy addresses dynamic spinal visualization technologies used to assess spinal motion, including digital motion x-ray (DMX) and cineradiography/videofluoroscopy, with or without digitization/computerized analysis. Anthem deems these services investigational and not medically necessary for all indications; therefore, they are not covered (e.g., for evaluation of back pain or other spinal/orthopedic conditions). Noncoverage applies to all settings and billing (e.g., CPT/HCPCS 76120, 76125, 76496) with no stated exceptions.

"Dynamic spinal visualization, including, but not limited to, digital motion x-ray of the spine, with or without digitization of spinal x-rays and computerized analysis of the back or spine, is cons..."

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