Policy Number: UM300POL
\nEffective Date: 6\/1\/2021
\nLOB Affected: Commercial, Medicare, Medicaid
\nPolicy Type: Medical<\/p>\n
Definitions<\/strong> From:<\/em> To:<\/em> \u2022 II., Criteria for Approval for Medicare Members with below Medicare Links: \u2022 IV., What is Not Covered \u2022 V., The following are considered investigational\/experimental: \u2022 CPT Codes: Added 63685 Policy Number: UM300POL Effective Date: 6\/1\/2021 LOB Affected: Commercial, Medicare, Medicaid Policy Type: Medical Definitions Added Nociceptive Pain and Spinal Cord Stimulator \u2022 I., Criteria for Approval B. o Added #2. o Changed 4: From: The treatment is a last resort, for chronic conditions with documentation of > 12 months of ineffective treatment and when […]<\/p>\n","protected":false},"author":1,"featured_media":4692,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-6417","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2019\/05\/GettyImages-519123626.jpg?fit=5400%2C3600","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1Fv","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6417","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=6417"}],"version-history":[{"count":3,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6417\/revisions"}],"predecessor-version":[{"id":6429,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6417\/revisions\/6429"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/4692"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=6417"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=6417"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=6417"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nAdded Nociceptive Pain and Spinal Cord Stimulator
\n\u2022 I., Criteria for Approval
\nB.
\no Added #2.
\no Changed 4:<\/p>\n
\nThe treatment is a last resort, for chronic conditions with documentation of > 12 months of ineffective treatment and when the pain is refractory to all other therapies(pharmacologic, surgical, psychological, and physical, when appropriate) or the therapies are considered unsuitable or contraindicated; and<\/p>\n
\nThe treatment is a last resort, for chronic conditions with documentation of > 12 months of ineffective treatment and when the pain is refractory to all other therapies (pharmacologic, surgical, psychological, and physical therapy, when appropriate) or the therapies are considered unsuitable or contraindicated; and
\no Added #7.<\/p>\n
\nThis section was added, and the remaining sections were re-numbered.<\/p>\n
\nA.: Added #6.<\/p>\n
\nDeleted the original F., G., and H.:
\nA. Post amputation pain (phantom limb pain)
\nB. Post herpetic neuralgia
\nC. Peripheral neuropathy<\/p>\n
\n\u2022 Updated all references.<\/p>\n","protected":false},"excerpt":{"rendered":"