CMM-207: Epidural Adhesiolysis

Epidural adhesiolysis (catheter or endoscopic) is considered experimental, investigational, and unproven for treatment of back pain and is therefore excluded from coverage; CPT codes 62263, 62264, 62280, 62281, and 62282 are specifically listed as experimental/investigational. No covered indications, prior‑authorization criteria, or specific documentation requirements are provided in the guideline due to insufficient scientific evidence.

"There is insufficient scientific evidence to support the use of epidural adhesiolysis, performed by catheter or endoscopically, as a treatment for back pain. It is considered experimental, investig..."

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