Aetna considers the use of MRI for further evaluation of unstable injury in neurologically intact individuals with blunt trauma after a negative cervical spine CT result not medically necessary.Clinical guidelines, including those from the Agency for Healthcare Policy and Research, have consistently recommended against routine imaging studies for acute low back pain. Aetna considers MRI and CT of the spine experimental and investigational for all other indications because their clinical value for indications other than the ones listed above has not been established.Suspected spinal fracture and/or dislocation secondary to trauma (if plain films are not conclusive) orįootnotes for conservative therapy * Conservative therapy = moderate activity, analgesics, non-steroidal anti-inflammatory drugs, muscle relaxants.Suspected spinal cord injury secondary to trauma or.Suspected infectious process (e.g., osteomyelitis epidural abscess of the spine or soft tissue) or.Spondylolisthesis and degenerative disease of the spine that has not responded to 4 weeks of conservative therapy Footnotes for conservative therapy* or.Severe back pain (e.g., requiring hospitalization) or.Rapidly progressing neurological deficit, or major motor weakness or.Progressively severe symptoms despite conservative management or.Primary spinal bone tumors or suspected vertebral, paraspinal, or intraspinal metastases or.Persistent back or neck pain with radiculopathy as evidenced by pain plus objective findings of motor or reflex changes in the specific nerve root distribution, and no improvement after 6 weeks of conservative therapy Footnotes for conservative therapy* or.Known or suspected primary spinal cord tumors (malignant or non-malignant) or.Known or suspected myelopathy (e.g., multiple sclerosis) for initial diagnosis when MRI of the brain is negative or symptoms mimic those of other spinal or brainstem lesions or.Follow-up of evaluation for spinal malignancy or spinal infection or.Evaluation prior to epidural injection to rule out tumor or infection and to delineate the optimal anatomical location for performing the injection or.Evaluation of recurrent symptoms after spinal surgery or.Diagnosis and evaluation of lumbar epidural lipomatosis or.Congenital anomalies or deformities of the spine or.Clinical suspicion of a spinal cord or cauda equina compression syndrome or.Clinical evidence of spinal stenosis or.This Clinical Policy Bulletin addresses magnetic resonance imaging (MRI) and computed tomography (CT) of the spine.Īetna considers magnetic resonance imaging (MRI) and computed tomography (CT) of the spine medically necessary when any of the following criteria is met: Number: 0236 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |