About this policy
CMS National Coverage Determination | ncd_id=124 | manual_section=160.16 | coverage_level_code=3 | national_coverage_type=True | under_review=False | lab_ncd=False
Coverage indications
There is insufficient scientific data to support the benefits of this technique. Therefore, VAX-D is not covered by Medicare.
Documentation requirements
Item/Service Description: Vertebral axial decompression is performed for symptomatic relief of pain associated with lumbar disk problems. The treatment combines pelvic and/or cervical traction connected to a special table that permits the traction application. Revision History: 3/1997 - Provided that VAX-D not covered by Medicare. Effective date 4/15/1997. (TN 93) Benefit Categories: 52 - Physicians' Services Transmittal: transmittal_number=93 | transmittal_issue_date=1997-03-01
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
Backwork has no codes on record for this policy. Check the source.