SURG.00096 Surgical and Ablative Treatments for Chronic Headaches

This policy addresses surgical and ablative treatments proposed for chronic headaches (including chronic migraine and chronic tension-type), such as resection or manipulation of facial/scalp soft tissues or muscles (e.g., corrugator supercilii), resection of trigeminal nerve branches, and patent foramen ovale closure. Anthem considers these procedures investigational and not medically necessary; they are not covered for chronic headache indications. There are no covered exceptions, and this noncoverage applies to chronic headaches (≥15 days/month for >3 months) and the procedures reflected by the listed CPT/HCPCS codes.

"Surgical treatment for chronic headaches (including but not limited to chronic migraine headache and chronic tension type headache) is consideredinvestigational and not medically necessary."

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