Effective March 17, 2025, Independence Administrators will be updating its Commercial policy on Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management.
The policy criteria for the following have been revised for members for whom Independence Administrators serves as the claims administrator and whose group has not enrolled in the UM vendor program:
- Paravertebral Facet Joint Blocks
- Repeat Injections For Transforaminal Epidural Injections And Paravertebral Facet Nerve Blocks
- Not Medically Necessary Criteria
The policy criteria were revised to provide parameters for use (e.g., persistent pain, failed conservative management, prior effectiveness).
CPT codes 64461 and 64462 have been removed from this policy, as they have been determined to be out of scope.
For more information
Please refer to the following Commercial policy in Notification status:
Note: This policy notification and its included link will expire and become unusable on March 17, 2025, when the new policy is issued.
To access the most updated version of any active policy, please refer to the Medical and Claim Payment Policy Portal or simply navigate to the Commercial or Medicare Advantage policy bulletins.
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