Interspinous Fusion and Decompression Devices (for Nebraska Only)
UnitedHealthcare medical policy (Nebraska only) on interspinous fixation (fusion) devices and interspinous/interlaminar decompression/stabilization devices, defining coverage criteria for interspinous fixation with fusion and noncoverage for interspinous decompression/stabilization devices used without fusion.
Medical Records Documentation Used for Reviews section updated to require explicit documentation supporting medical necessity and to add language about legibility and availability upon request.
Definitions for Arthrodesis, Interlaminar Lumbar Instrumented Fusion (ILIF), Interlaminar Stabilization Device, and Neurogenic Claudication were updated.
Supporting Information sections (Description of Services, Clinical Evidence, FDA, References) were updated to reflect current information.
Updated medical records documentation language to require documentation that fully supports medical necessity and to list required content (history, exam, diagnostic tests).
Updated definitions for Arthrodesis, Interlaminar Lumbar Instrumented Fusion (ILIF), Interlaminar Stabilization Device, and Neurogenic Claudication.
Updated supporting information including Description of Services, Clinical Evidence, FDA, and References sections to reflect current information.
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