Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting) - (CPG275)

Cigna covers clinic-based mechanical cervical and lumbar traction (CPT 97012) only when strict diagnostic and clinical criteria are met, while nonsurgical axial/spinal decompression devices (e.g., VAX‑D, IDD, DRX series), HCPCS S9090, and thoracic mechanical traction are considered experimental/unproven and not covered. Coverage requires documentation of failure of other evidence‑based therapies for ≥3 weeks, use only in combination with therapeutic exercise (lumbar: extension movements), and specific findings — cervical: cervical radiculopathy plus ≥3 of 5 listed tests; lumbar: sciatica/nerve‑root signs plus peripheralization with extension or a positive crossed straight leg raise.

"Cervical mechanical traction is considered medically necessary in the clinic setting for patients who meet ALL of the following criteria: Failure of other evidence-based therapeutic procedures to r..."