CMM-209: Regional Sympathetic Blocks

Initial diagnostic regional sympathetic blocks (stellate ganglion or lumbar sympathetic) are covered to establish sympathetically mediated CRPS—with up to three additional diagnostic blocks within two weeks after a successful initial block—but blocks are not covered as isolated long‑term treatment, when the patient is unable/not participating in active rehabilitation, or when performed without fluoroscopic guidance. Key requirements: documentation of ≥50% pain reduction and functional improvement for the duration of the local anesthetic after the diagnostic block, fluoroscopic guidance, and for additional therapeutic blocks evidence of decreased pain‑medication use, increased function and tolerance to touch, ongoing active rehabilitation, no more than one block per week and no more than six total, plus clinical justification that blocks facilitate rehabilitation.

"Documentation that fluoroscopic guidance was used during the procedure."