Anthem Blue Cross Connecticut Commercial Clinical Policy

Anthem Blue Cross Connecticut SURG.00092 Implanted Devices for Spinal Stenosis Form

Effective Date

09/27/2023

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses devices for the treatment of spinal stenosis. Spinal stenosis is a narrowing of the spinal canal diameter in the cervical or lumbar areas and can result in compression of the nerve roots or spinal cord. Interspinous process spacer devices are constructed to widen or open the foramen, allowing the spinal nerves to pass through more freely.

Note: Please see the following related documents for other treatments of stenosis of the spine:

  • SURG.00071 Percutaneous and Endoscopic Spinal Surgery
  • SURG.00075 Intervertebral Stabilization Devices
  • SURG.00134 Interspinous Process Fixation Devices

Position Statement

Investigational and Not Medically Necessary:

Implanted devices for treatment of spinal stenosis are considered investigational and not medically necessary.

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