Interspinous Fixation (Fusion) Devices

This policy concerns interspinous fixation (fusion) devices used as supplemental posterior fixation or decompression adjuncts in lumbar spine procedures, including use with interbody fusion or proposed stand‑alone use for spinal stenosis and spondylolisthesis. However, all uses are considered experimental/investigational and not covered except for limited clinical exceptions (e.g., patients with small pedicles where pedicle screws cannot be safely placed); major limitations include intended adjunctive use with interbody fusion (not stand‑alone), single‑level L1–S1 application only, not for spondylolisthesis > Grade 1, placement under direct visualization, and coverage subject to the member’s benefit plan.

"Interspinous fixation (fusion) devices are considered experimental, investigational and/or unproven and therefore not covered for any indication."

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