Peripheral Nerve Blocks and Procedures for Chronic Pain

Radiofrequency neurolysis is covered for trigeminal neuralgia only after ≥6 months of symptoms, failure or intolerance of medical therapy, patient is not a surgical candidate or declines surgery, and diagnostic nerve block demonstrates ≥75% improvement; RFN is limited to two treatments in a rolling 12-month period. Corticosteroid injections (with or without local anesthetic) are covered for carpal tunnel syndrome (max 3 per lifetime per side) and Morton's neuroma (max 2 per lifetime per side), while local-anesthetic-only peripheral nerve blocks for CTS, peripheral denervation for CTS, dry needling, and many therapeutic PNBs/denervations for specified nerves are non-covered or investigational. Documentation requirements include proof of prior treatment failure/intolerance, diagnostic block response for TN, and clear justification when deviations (e.g., sedation, same-day multiple procedures, implanted devices) are used.

"Radiofrequency neurolysis (RFN) is medically reasonable and necessary for trigeminal neuralgia when all are met: symptoms ≥6 months, failure or intolerance of medical therapy (e."