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Medical Policy Revision: Spinal Cord and Implantable Peripheral Nerve Stimulators

EffectiveDecember 10, 2019, Horizon BCBSNJ will change the way we consider certain professional claims based on revisions to our medical policy, Spinal Cord and Implantable Peripheral Nerve Stimulators.

Access our Medical Policy Manual to review this medical policy content.

Regardless of the submitted diagnosis code(s), claims submitted for services provided on and afterDecember 10, 2019 to patients enrolled in Horizon BCBSNJ commercial or Administrative Services Only (ASO) plans will be processed as follows.

  • Information will be requested to help us determine the medical appropriateness of the services represented by CPT® code95970,95971 and95972. Following our review of medical record information, these services may be denied as not medically necessary.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been canceled or postponed, the changes will be applied to claims for dates of service on and afterDecember 10, 2019.

CPT® is a registered mark of the American Medical Association.

Published on: September 9, 2019, 07:10 a.m. ET
Last updated on: June 23, 2021, 08:50 a.m. ET