Interspinous Process Decompression Spacers - Medicare Advantage

This policy addresses interspinous process decompression spacers (e.g., Superion/Vertiflex) implanted between lumbar spinous processes to relieve neurogenic claudication from lumbar spinal stenosis, typically at one or two levels. Although described for patients who have failed conservative nonsurgical care and for FDA‑approved devices, the policy states these spacers are not considered medically reasonable and necessary and therefore are not covered, with coverage subject to Medicare reasonable‑and‑necessary rules and device/level limitations.

"No documentation requirements are specified in this document."

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