Anthem Blue Cross Connecticut CG-DME-09 Continuous Local Delivery of Analgesia to Operative Sites using an Elastomeric Infusion Pump during the Post-Operative Period Form

Effective Date

09/27/2023

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses the use of the elastomeric infusion pump as a means of local delivery of analgesia to operative sites during the post-operative period. These pumps are designed to reduce post-operative pain, while limiting the systemic side effects of analgesia.

This document does not address the use of infused analgesia or anesthesia during an operative procedure.

Clinical Indications

Not Medically Necessary:

Continuous local delivery of analgesia to operative sites using an elastomeric infusion pump during the post-operative period is considered not medically necessary as a technique of postoperative pain control.