SURG.00155 Cryosurgery of Peripheral Nerves

This policy addresses cryosurgical techniques on peripheral nerves (cryoneurolysis/cryoablation), including devices such as iovera and AtriCure’s CryoSphere/cryoICE used for temporary nerve blocks. Anthem deems these services investigational/experimental and not medically necessary; they are not covered for any indication. There are no exceptions—this applies to all uses (e.g., peripheral nerve pain or intercostal nerve blockade during chest procedures), regardless of device or diagnosis.

"Cryosurgical techniques (for example, cryoneurolysis and cryoablation) of peripheral nerves are consideredinvestigational and not medically necessaryfor all indications."

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