Epidural Steroid Injections for Spinal Pain – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers epidural steroid injections (interlaminar, transforaminal, caudal) for radicular spinal pain but excludes ESI for non‑radicular back pain, ultrasound‑guided ESI, and situations with contraindications (e.g., spinal neoplasm, rapidly progressive neurologic deficit, epidural abscess). Coverage requires documented radicular pain on history/physical, ≥4 weeks of failed conservative therapy, objective imaging or electrodiagnostic evidence of nerve‑root involvement, fluoroscopic/CT guidance, specified documentation for repeat injections, and is limited to four sessions per region per 12‑month period.

"Epidural Steroid Injections (ESI) are proven and medically necessary when all of the following criteria are met: The injection is intended for the management of Radicular Pain as evidenced by histo..."

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