Anthem Blue Cross ConnecticutCommercial Clinical Policy

CG-SURG-25 Injection Treatment for Morton’s Neuroma Form

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Injection Treatment for Morton's Neuroma

Notes: Injections are considered medically necessary after all other conservative therapies have failed.

Indications

(584695) Has the patient used padding or orthotic devices to reduce pressure and compression on the nerve? 
(584696) Has the patient modified their activities to reduce repetitive pressure on the nerve? 
(584697) Has the patient changed shoe wear to shoes with a wide toe box to reduce compression of the metatarsal heads and pressure on the nerve? 
(584698) Has the patient used medications, unless otherwise contraindicated (e.g., nonsteroidal anti-inflammatory drugs), to help reduce inflammation? 

Effective Date

06/28/2023

Last Reviewed

05/11/2023

Original Document

  Reference



This document addresses the indications for injection treatment of Morton's neuroma, a common paroxysmal neuralgia affecting the web spaces of the toes. 

Clinical Indications

Medically Necessary:

Injections of anesthetic, sclerosing (neurolytic), or steroid agents are considered medically necessary for treatment of Morton’s neuroma when all of the following conservative therapies have failed:

  1. Padding or orthotic devices (these can provide support to reduce pressure and compression on the nerve); and
  2. Activity modification (to reduce repetitive pressure on the nerve); and
  3. Changes in shoe wear (that is, shoes with a wide box toe reduce compression of the metatarsal heads and reduce pressure on the nerve); and
  4. Medications unless otherwise contraindicated (for example, nonsteroidal anti-inflammatory drugs which help reduce inflammation).

Not Medically Necessary:

Injection treatment of Morton’s neuroma is considered not medically necessary when the above criteria are not met.