Epidural Steroid Injections for Spinal Pain (ESIs)
Defines UnitedHealthcare Commercial and Individual Exchange medical policy coverage criteria, limits, contraindications, coding references, and evidence summary for epidural steroid injections (ESIs) for radicular spinal pain.
No material clinical or coverage changes.
Coverage Summary
Epidural Steroid Injections (ESIs) are a nonsurgical treatment option for radiculopathy caused by disc herniation or degenerative changes, intended to relieve pain and improve function. Evidence supports short-term benefit for radicular (radicular back) pain, while there is insufficient evidence for effectiveness in nonradicular back pain. Coverage requires documentation of nerve root involvement by imaging or electrodiagnostic studies, and the procedure must be performed with fluoroscopic or computed tomography (CT) guidance. Scope: Defines UnitedHealthcare Commercial and Individual Exchange coverage criteria, limits, contraindications, coding references, and evidence summary for ESIs for radicular spinal pain.