Implanted Electrical Stimulator for the Spinal Cord – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers implanted spinal cord stimulators for CRPS, painful lower-limb diabetic neuropathy, and failed back surgery syndrome, and covers DRG stimulation only for refractory CRPS I/II, while deeming SCS/DRG unproven and not medically necessary for other indications (e.g., chronic intractable back pain without prior surgery, refractory angina). Coverage requires adherence to FDA-labeled indications/precautions and InterQual clinical criteria, may require medical-record documentation (including proof a replacement generator is malfunctioning/unrepairable/out of warranty), and is subject to the member’s specific benefit plan and applicable laws.

"Implanted electrical spinal cord stimulators are proven and medically necessary for treating the following conditions in certain circumstances, when performed according to U."

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