Ablative Treatment for Spinal Pain – Commercial and Individual Exchange Medical Policyopen_in_new

This policy addresses coverage of ablative treatments for spinal pain, including thermal radiofrequency ablation and related techniques (e.g., pulsed RFA, cooled RFA, cryoablation, endoscopic rhizotomy, and intraosseous basivertebral nerve procedures) for conditions such as lumbar facet syndrome, lumbar or cervical radicular pain from herniated disc or prior failed surgery, and spinal stenosis. Major limitations: several techniques (pulsed RFA of facet nerves, endoscopic rhizotomy, cryoablation, cooled RFA, chemical/laser ablation, and intraosseous basivertebral nerve ablation/Intracept) are considered unproven and not medically necessary due to insufficient evidence, conventional thermal RFA requires site-of-service review, and coverage is subject to member benefit documents and coding rules.

"Study limitations include lack of randomization and control."

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