CMM-207: Epidural Adhesiolysis

EviCore classifies epidural adhesiolysis (catheter- or endoscopy-based; CPT 62263, 62264, 62280–62282) for treatment of back pain as experimental, investigational, or unproven and therefore not supported as a covered indication. No specific documentation requirements are specified; final reimbursement is determined by the individual’s health plan/benefit rules and atypical cases require physician review/consultation.

"None — the document states that epidural adhesiolysis, performed by catheter or endoscopically, as a treatment for back pain is considered experimental, investigational, or unproven (EIU)."

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