Addendum to eviCore Guidelines

This addendum allows discography, greater occipital nerve blocks, neurolytic lesion creation, epidurography, spinal fluoroscopy, ankle and subtalar arthroscopy only when strict, procedure‑specific medical necessity criteria are met and excludes procedures in the presence of red‑flag conditions (e.g., infection, unstable fracture, cauda equina, suspected metastasis), functional anesthetic discography, standalone chemonucleolysis, and limits such as more than six occipital nerve blocks in 12 months or blocks less than 4 weeks apart. Key requirements are documented absence of red flags, specific history/physical findings, prior conservative therapy trials, supporting pre‑procedure imaging/formal radiology reports, comprehensive headache evaluation for occipital blocks, imaging guidance for neurolysis, and opioid co‑management plans when applicable.

"General: For discography a post-discography CT scan is automatically approved as an add-on (i."