Anthem Blue Cross Connecticut Commercial Clinical Policy

Anthem Blue Cross Connecticut SURG.00008 Mechanized Spinal Distraction Therapy Form

Effective Date

09/27/2023

Last Reviewed

08/10/2023

Original Document

  Reference



This document addresses the use of mechanized spinal distraction therapy. There are many devices currently available that are used for this therapy, including, but not limited to the Vertebral Axial Decompression (VAX-D®) Therapeutic Table, the Decompression Reduction Stabilization DRS® System and the Accu-Spina System™ IDD Therapy.

Position Statement

Investigational and Not Medically Necessary:

Use of mechanized spinal distraction therapy, including, but not limited to, the VAX-D® Therapeutic Table, the Decompression Reduction Stabilization DRS® System, and Accu-Spina System™ IDD Therapy, is considered investigational and not medically necessary for the treatment of low back pain or any other condition.

Want to learn more?