Anthem Blue Cross Connecticut DME.00025 Self-Operated Spinal Unloading Devices Form

This document addresses self-operated spinal unloading devices, which are designed to support the upper body’s weight and transfer that weight to the hips via a mechanical or pneumatic mechanism. Self-operated spinal unloading has been suggested as a conservative treatment for pain related to spinal disc disease or joint dysfunction. Several self-operated spinal unloading devices are currently available on the market, such as the LTX 3000^™ and the Lumbar Hometrac^®.

Position Statement

Investigational and Not Medically Necessary:

Self-operated spinal unloading devices including, but not limited to, gravity-dependent and pneumatic devices, are considered investigational and not medically necessary for all indications including, but not limited to, the treatment of low back pain and scoliosis.