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    v1.0.31
    OpenPayerPolicy UpdatesBlue Shield of CaliforniaBlue Shield CA Neuroma Ablation Coverage | OpenPay…
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    CurrentBlue Shield of CaliforniaPolicy 7.01.147

    Minimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas

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    This policy governs intralesional alcohol injection, radiofrequency ablation, and cryoablation used to treat Morton neuroma and other peripheral neuromas. These procedures are considered investigational because evidence is insufficient to establish improved net health outcomes.

    Policy Summary
    PayerBlue Shield of California
    PolicyMinimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas
    Policy CodePolicy N/A
    Change TypeNo material change
    Effective DateAugust 1, 2026
    Next Review DateN/A
    Key ActionTreat intralesional alcohol injection, radiofrequency ablation, and cryoablation for Morton or other peripheral neuromas as investigational.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    3Investigational ablation modalities
    InsufficientEvidence determination for ablation procedures
    None identifiedEvidence for other peripheral neuromas
    No records required

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    Clinical review documentation
    3CPT codes listed

    Investigational Coverage Criteria

    Minimally invasive ablation procedures

    The following procedures are considered investigational when used for the listed conditions.

    Investigational minimally invasive ablation

    • Ablation modality

      • The procedure is intralesional alcohol injection.
      • The procedure is radiofrequency ablation.
      • The procedure is cryoablation.

    • Neuroma type

      • The condition treated is Morton neuroma.
      • The condition treated is another peripheral neuroma.

    Investigational minimally invasive ablation procedures

    The following minimally invasive ablation procedures are considered investigational for treatment of Morton and other peripheral neuromas.

    Investigational procedures

    • Intralesional alcohol injection for treatment of Morton or other peripheral neuromas is considered investigational.
    • Radiofrequency ablation for treatment of Morton or other peripheral neuromas is considered investigational.
    • Cryoablation for treatment of Morton or other peripheral neuromas is considered investigational.

    Investigational CPT Codes

    Investigational CPT CodesCPTExperimental
    0441TAblation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve
    64632Destruction by neurolytic agent; plantar common digital nerve.
    64640Destruction by neurolytic agent; other peripheral nerve or branch.

    Provider and Clinical Review Guidance

    Documentation Required

    No clinical review records required

    No records are required for clinical review.

    Denial Risk

    Ablation procedures are investigational

    Intralesional alcohol injection, radiofrequency ablation, and cryoablation are considered investigational for the treatment of Morton and other peripheral neuromas, creating a denial risk.

    • Intralesional alcohol injection
    • Radiofrequency ablation
    • Cryoablation

    Definitions and Abbreviations

    Morton neuroma
    DefinitionA common and painful compression neuropathy of the common digital nerve of the foot.
    Also calledInterdigital neuroma or interdigital neuritis.
    Additional terminologyInterdigital or Morton metatarsalgia.
    Radiofrequency ablation (RFA)
    ProcedureRadiofrequency ablation (RFA) uses an electrode-generated electromagnetic current to treat tissue or a lesion.
    MechanismThe electromagnetic current generates heat in the tissue or lesion.
    Tissue effect
    Policy Summary
    PayerBlue Shield of California
    PolicyMinimally Invasive Ablation Procedures for Morton and Other Peripheral Neuromas
    Policy CodePolicy N/A
    Change TypeNo material change
    Effective DateAugust 1, 2026
    Next Review DateN/A
    Key ActionTreat intralesional alcohol injection, radiofrequency ablation, and cryoablation for Morton or other peripheral neuromas as investigational.
    SourceLink
    On This Page
    Investigational Coverage CriteriaInvestigational CPT CodesProvider and Clinical Review GuidanceClinical BackgroundDefinitions and Abbreviations
    Denial Risk

    Verify investigational status before treatment

    Minimally invasive ablation procedures, including intralesional alcohol injection, radiofrequency ablation, and cryoablation, are considered investigational for the treatment of Morton and other peripheral neuromas.

    • Applies to Morton neuromas
    • Applies to other peripheral neuromas
    Heat denatures proteins and destroys cells.
    Cryoablation
    ProcedureCryoablation freezes and kills tissue using a cryoprobe.
    TemperatureThe cryoprobe is cooled below -75°C.
    Also calledCryoneurolysis, cryolysis, or cryoanalgesia.
    Intralesional alcohol injection
    ProcedureIntralesional alcohol injection delivers dehydrated ethanol into the neuroma.
    Primary mechanismEthanol causes chemical neurolysis of the nerve pathology.
    Tissue injuryThe mechanism includes nerve-cell dehydration, necrosis, and related tissue injury.
    Radiofrequency ablation (RFA)
    Energy sourceRFA uses heat generated by an electrode.
    Energy deliveryThe electrode conducts electromagnetic energy into tissue or a lesion.
    ResultThe heat denatures proteins and destroys cells.
    Cryoablation
    Cooling methodCoolant chills a cryoprobe to temperatures below -75°C.
    ProcedureThe cryoprobe is inserted into a lesion.
    ResultFreezing kills the tissue; the procedure is also called cryoneurolysis, cryolysis, or cryoanalgesia.
    Intralesional alcohol injection
    SubstanceDehydrated ethanol is injected into nerve pathology.
    Chemical effectEthanol causes chemical neurolysis of the nerve pathology.
    Cellular effectsNerve-cell dehydration, necrosis, and Wallerian degeneration occur; ethanol also causes precipitation of protoplasm.
    Evidence abbreviations
    RFARadiofrequency ablation.
    SRSystematic review.
    M-AMeta-analysis.
    VASVisual analog scale.
    MDMean difference.
    CIConfidence interval.
    AOFAS
    AOFASAmerican Orthopaedic Foot and Ankle Society.
    Scale nameLesser Toe Metatarsophalangeal-Interphalangeal Scale.
    Use in evidenceThe scale is reported as an outcome measure in a study of ultrasound-guided RFA for Morton neuroma.
    Cryotherapy or cryoneurolysis
    DefinitionCryotherapy or cryoneurolysis uses a cryoprobe to freeze the neuroma or affected nerve tissue.
    Cryoprobe actionThe cryoprobe creates an ice ball around the targeted tissue during freezing.
    TargetThe treated target may be a Morton neuroma or other affected peripheral nerve tissue.