IntPainManage-06

Interventional Pain Management

Indicates Non-Covered Service

Acupuncture

-Aetna-

-Humana-

Acupuncture for Chronic Lower Back Pain (cLBP)

Back Pain - Invasive Procedures

-Aetna-

Botulinum Toxins

Continuous Peripheral Nerve Blocks

(CPNB)

Dorsal Column Stimulation

Transforaminal Epidural Injections

-Aetna-

Selective Nerve Root Blocks & Transforaminal Epidural Steroid Injections

Epidural Injections

-Cigna-

-FloridaBlue-

Epidural & Selective Nerve Root Block (SNRB)

-Medicare-

Epidural Steroid Injections for Spinal Pain

Epidural Patching

-Aetna-

Extended release opioids

Opioid Days' Supply Limitation

Radiofrequency Joint Ablation/Denervation

Facet Joint Interventions

Facet Joint Interventions for Pain Management

Facet Joint Injections

-FloridaBlue-

Facet Joint Injections/Medial Branch Blocks

-Humana-

-Cigna-

Facet Joint Injections for Spinal Pain

-UHC-

Injection of Morton's neuroma

Injections for Chronic Pain Conditions

-Humana-

Nerve Blockade for Treatment of Chronic Pain & Neuropathy

-Aetna-

Nerve Block Injections

-Aetna-

-FloridaBlue-

Ablative Treatment for Spinal Pain

-UHC-

MONITORED ANESTHESIA CARE (MAC) for Interventional Pain Management Procedures in an Adult

MODERATE SEDATION for Interventional Pain Management Procedures in an Adult

Neuroablative Techniques for Chronic Pain

-FloridaBlue-

-Humana-

Peripheral

Nerve

Blocks

-Medicare-

Percutaneous Electrical Nerve Stimulation (PENS)

-FloridaBlue-

Percutaneous Vertebral Disc

& Vertebral Endplate Procedures

-Anthem-

Post-Herpetic Neuralgia

Treatment

-Aetna-

Sacroiliac Joint Injection

-Cigna-

-FloridaBlue-

Spasticity Management

-Aetna-

Spinal Cord Stimulation

-Aetna-

-Anthem-

Spinal Cord Stimulation (Dorsal Column Stimulation)

Spinal Cord & Dorsal Root Ganglion Stimulation

-Cigna-

Tendon Sheath and Ligament Injections

-FloridaBlue-

Transcutaneous Electric Nerve Stimulation (TENS)

-FloridaBlue-

Trigger Point

Injections

-FloridaBlue-

-Humana-

-Medicare-

-FloridaBlue-

-UHC-

Minimally Invasive Spine Surgery Procedures & Trigger Point Injections

Visco-supplemen-tation

-Aetna-

-Cigna-

Visco-supplemen-for Osteoarth-ritis

-Cigna-

-Blue-

Indicates Non-Covered Service

Anesthetic & Antiemetic Infusion Pumps

-Aetna-

Discogenic

Pain

Treatment

-UHC-

Epidural Adhesiolysis

-Cigna-

-FloridaBlue-

Headache & Occipital Neuralgia Treatment

-Cigna-

Headaches: Invasive Procedures

-Aetna-

Intra-oral Appliances for Headaches & Trigeminal Neuralgia

Orthopedic Applications of Stem-Cell Therapy

-Cigna-

-Aetna-

-FloridaBlue-

Intravenous Lidocaine for the Management of Chronic Pain

Peripheral Nerve Stimulation and Peripheral Nerve Field Stimulation

Surface Scanning & Macro Electromy-ography

Visco-

supplements

-FloridaBlue-

-Cigna-

-Aetna-

• 0213T, 0214T, 0215T, 0216T, 0217T, 0218T, 0627T, 0628T, 0629T, 0630T, 22526, 22527, 22899, 27096, 27299, 62287, 62320, 62321, 62322, 62323, 62324, 62325, 62326, 62327, 62380, 64451, 64479, 64480, 64483, 64484, 64490, 64491, 64492, 64493, 64494, 64495, 64625, 64628, 64629, 64633, 64634, 64635, 64636, 64999, G0260, S2348, 62324, 62325, 62326, 62327, 62350, 62351, 62360, 62361, 62362, 64999, C1772, C1891, C2626, E0782, E0783, E0785, E0786