CMM-208: Radiofrequency Joint Ablations/Denervations

Covered: radiofrequency joint denervation/ablation is medically necessary only for facet‑mediated spinal pain when other pain sources are excluded and the procedure is performed with fluoroscopic guidance (no more than three contiguous levels per session); pulsed/cooled RF, endoscopic denervation, cryo/chemical/laser ablation, SI‑joint ablation, procedures above C2‑3 or below L5‑S1, untreated radiculopathy, posteriorly fused segments (except suspected pseudarthrosis) and more than two procedures at the same level in 12 months are excluded or considered investigational/not medically necessary. Key requirements: documentation of ≥3 months conservative therapy (or contraindication), two positive diagnostic medial branch/facet blocks with ≥80% relief for initial RFA, records of levels treated and fluoroscopic use, and for repeat RFA documented ≥50% pain relief lasting ≥12 weeks and performed ≥6 months after the prior denervation (no repeat diagnostic blocks required if prior denervation was successful at the same level).