SURG.00140 Peripheral Nerve Blocks for Treatment of Neuropathic Pain

This policy addresses the use of peripheral nerve blocks for the treatment of neuropathic pain. Anthem considers this service investigational and not medically necessary; therefore, it is not covered for neuropathic pain of any cause, including chemotherapy-induced peripheral neuropathy, chronic nonmalignant pain, peripheral neuropathies (e.g., diabetic, HIV-related), and trauma-induced neuropathy. There are no covered indications under this policy; relevant codes include CPT/HCPCS 64415, 64417, 64447, 64450, 64510, 64520, 64999 and ICD-10 codes such as B02.23, E08.40/E08.49, E09.40/E09.49, E10.40/E10.49, E11.40/E11.49, and E13.40.

"Peripheral nerve blocks are consideredinvestigational and not medically necessaryfor management of neuropathic pain,including but not limited to treatment ofanyof the following:"

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