October 4, 2022
Important news! United Healthcare’s new policy reverses the previous policy with a limit of three (3) epidural injections to the ASIPP recommendation of four (4) procedures per year.
As you know, ASIPP has resolutely advocated for the change in the policy on epidural injection limits of three (3) per year through evidence-based presentations and communication. We first sent a letter on June 21, and they responded on June 27. Since then, we have continued with multiple other correspondences. Consequently, they published the new policy effective November 1, 2022, which now provides coverage for four (4) procedures.
Coverage rationale and documentation requirements have also changed somewhat more favorably for physicians. See United Healthcare Policy.
As a reminder, after much effort and many correspondences on the part of ASIPP, percutaneous adhesiolysis is now covered in all states, following the reversal of noncoverage policies of Noridian and Palmetto.
We are still awaiting the response from Centene in reference to continuation of the epidural injections when indicated beyond one year. We will keep you posted with the developments. See Letter to Centene.