Peripheral Nerve Blocks and Procedures for Chronic Pain

RF neurolysis is covered for trigeminal neuralgia only when symptoms persist ≥6 months, medical therapy has failed or is not tolerated, surgery is not an option or declined, and diagnostic block produced ≥75% pain relief; RF treatments are limited to 2 within any rolling 12 months. Corticosteroid injections (with or without local anesthetic) are covered for carpal tunnel syndrome and Morton's neuroma, subject to lifetime-per-side limits (CTS: 3 injections; Morton's: 2 injections); local-anesthetic-only PNBs for CTS and denervation for CTS are not covered. Many peripheral nerve ablation/denervation procedures for specified nerves and PNBs for diffuse or investigational indications are not covered, and documentation of prior treatments and justification for exceptional anesthesia or same-day multiple procedures is required.

"Radiofrequency neurolysis (RFN) for trigeminal neuralgia is covered when the condition has been present ≥6 months, is non-responsive to or intolerant of medical therapy (e."