CMM-405: Spinal Fluoroscopy

Fluoroscopic imaging guidance for spinal/paraspinal procedures is covered only when performed with a spinal/paraspinal diagnostic or therapeutic injection, when needle/catheter placement cannot be adequately done without image guidance, and when imaging guidance is not already included in the planned procedure; separate billing of fluoroscopy that is integral to a planned procedure is not medically necessary. Required documentation must link the imaging to the primary injection, justify why image guidance is necessary, confirm imaging isn’t included in the planned procedure, verify no X‑ray contraindications, and meet any payor-specific prior‑authorization or review requirements.

"This guideline only applies to fluoroscopically guided spinal procedures (non-spinal fluoroscopic procedures are outside the scope of this guideline)."

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