Surgery & Injections
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Indicates Non-Covered Service
Anterior Cervical Decompression with Fusion (ACDF) - Single Level (elective)
Anterior Cervical Decompression with Fusion (ACDF) - Multiple Level (elective)
-Humana-
Cervical Artificial Disc Replacement - Single or Two Level (elective)
Cervical Fusion for Treatment of Axial Neck Pain (elective)
Cervical Posterior Decompression with Fusion – Multiple levels (urgent/emergent)
Cervical Posterior Decompression with Fusion – Multiple levels (urgent/emergent)
Cervical Posterior Decompression with Fusion - Single Level (elective)
Cervical Spinal Fusion
Cervical Laminectomy Other Than for Herniated Disc
Cervical Laminectomy for Herniated Disc
Cervical Laminoplasty
Cervical Spine Indications for Referrals
Cervical
Spine Procedures
Cluster & Migraine Headache: Nonsurgical Management
Complex Regional Pain Syndrome (RSD)
Deep Brain Stimulation for Essential Tremor & Parkinson's Disease
Selective Dorsal Rhizotomy for Cerebral Palsy
Endoscopic & Percutaneous Lysis of Epidural Adhesions
Epidural Lysis of Adhesions
-Anthem-
-Humana-
-Medicare-
-Cigna-
-FloridaBlue-
-Humana-
Electrical Bone Growth Stimulation: Noninvasive
Facet
Arthroplasty
-Humana-
Non-covered
Growing Rods for Spinal Surgery
Hydrodissection
-Humana-
Non-covered
Implantable Infusion Pump for Pain & Spasticity
Implantable Infusion Pump for the Treatment of Chronic Intractable Pain Opioid
Drugs
Implantable Infusion Pump for the Treatment of Chronic Intractable Spasticity
Interspinous & Interlaminar Stabilization/Distraction (Spacers) & Fixation (Fusion) Devices
Interspinous Process Decompression
Laminectomy, Laminotomy, Facetectomy, & Foraminotomy (elective)
Laser Interstitial Thermal Therapy
-Humana-
-FloridaBlue-
-Cigna-
-Humana-
Lumbar Discectomy/Microdiscectomy (elective)
Lumbar Spinal Fusion
Lumbar Spine Indications for Referral
Lumbar Spinal Procedures
Lumbar Total Disc Arthroplasty (TDA)
Minimally Invasive Ablative Procedures for Epilepsy
Multi-level Lumbar Fusions with or without decompression (elective)
-Aetna-
Occipital Nerve Injections & Ablation (Including Occipital Neuralgia & Headache)
Occipital Nerve Stimulation
-FloridaBlue-
Surgical Treatment of Occipital Neuralgia & Headache
-FloridaBlue-
Optic Nerve Decompression Surgery
-UHC-
Osteopathic Manipulative Treatment
Pedicle Screws for Spinal Fixation & Intervertebral Body Fusion Devices
Percutaneous Vertebral Augmentation (Vertebral Augmentation) (Formerly Kyphoplasty)
Peripheral Nerve Stimulation & Peripheral Nerve Field Stimulation
Cigna-
Repeat Lumbar Spine Fusion Operations (elective)
Humana
Scoliosis
& Spinal Deformity
Spasticity Management
Thoracic Laminectomy (and/or Thoracic Diskectomy & Fusion)
Minimally invasive Surgical (MIS) Fusion of the Sacroiliac (SI) Joint (L36406)
Selective Peripheral Denervation (Bertrand Procedure)
-FloridaBlue-
-Medicare-
Single Level Lumbar Fusion with or without decompression (elective)
Stereotactic Cingulotomy
& Capsulotomy
Thalamotomy
-Aetna-
20974, 20975, 20979, E0747, E0748, E0749, E0760, 62324, 62325, 62326, 62327, 62350, 62351, 62360, 62361, 62362, 64999, C1772, C1891, C2626, E0782, E0783, E0785, E0786,
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