Documentation and Medical Necessity - Ablative Treatment for Spinal Pain - UHC Medical Policy

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
September 21st, 2015

According to UnitedHealthcares policy: For chronic cervical, thoracic and lumbar pain, Thermal radiofrequency ablation of facet joint nerves is proven and medically necessary when confirmed by the following:

UHC policy also states, Thermal radiofrequency ablation is proven and medically necessary:

and is unproven and not medically necessary:

The policy states "Ablation procedures performed more frequently than every 6 months increase the risk of adverse events without improving the clinical outcome".

Required documentation for the above procedures must include:

Thermal radiofrequency ablation is considered unproven and not medically necessary for the treatment of all other causes of spinal pain including but not limited to the following:

 Coding Clarification CPT codes 646336463464635, and 64636 only apply to thermal radiofrequency ablation. CPT code 64999 is to be used for pulsed radiofrequency ablation.

Read the entire Policy here


Documentation and Medical Necessity - Ablative Treatment for Spinal Pain - UHC Medical Policy. (2015, September 21). Find-A-Code Articles. Retrieved from

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)

Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
free demo
request yours today
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.