Mechanized Spinal Distraction Therapy

Anthem · PayerPolicy · ANTHEM-SURG.00008

Summary of the payer’s published policy. Not a coverage determination — confirm with Anthem before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
97039	CPT	Not covered
S9090	HCPCS	Not covered