Dynamic Spinal Visualization and Vertebral Motion Analysis

This policy addresses dynamic spinal visualization (including digital motion X‑ray and dynamic MRI protocols) and vertebral motion analysis (computerized tracking with controlled movement) used to evaluate spinal disorders such as neck and back pain, spondylolisthesis, suspected radiographic instability, cervical spondylotic myelopathy, and to assess prior spinal fusion. These techniques are considered experimental/investigational and are not covered because of insufficient evidence of clinical validity and utility, variable image quality, lack of standardized billing codes, and coverage is subject to the member’s benefit plan and applicable state regulations.

"Use of dynamic spinal visualization technologies to evaluate spinal disorders, including neck and back pain"

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