Cervical

Traction

Devices

Commodes

Continuous Passive Motion (CPM) Machines

Custom Knee Braces

Prefabricated & Prophylactic Knee Braces

CT

 Pelvis

CT

Thorax

CT

Spine

MRI

Lumbar  With

“Red Flags”

MRI

Lumbar  Without

“Red Flags”

MRI Lower Extremities

MRI

Upper Extremity

MRI of Joints

MRI

Spine

Magnetic Resonance Imaging (MRI) of the Knee

NM

Bone and/or Joint Imaging

Non-Invasive Evaluation of Extremity Veins

Non-Vascular Extremity Ultrasound

3D Interpretation & Reporting of Imaging

Studies

Bone

Mass

Measurement

Ablative

Therapy of Bone

Ankle,

Arthroscopy

Ankle,

Revision Total

Replacement

Ankle, Total Replacement

Arthrocentesis

Autologous Chondrocyte Implantation (ACI)

Botulinum Toxin Type A & Type B

Bunion

Surgery

Cervical Artificial Intervertebral

Disc

Cervical Laminectomy Other Than for Herniated Disc

Cervical Laminoplasty

Cervical Spinal Fusion

Cervical Laminectomy for Herniated Disc

Coccygectomy & Treatments for Coccydynia

Collagenase Clostridium Histolyticum (Xiaflex ®) for Dupuytren's Contracture

Complex Regional Pain Syndrome (RSD)

Continuous Peripheral Nerve Blocks

(CPNB)

Core Decompression for Avascular Necrosis

Debridement of Mycotic Nails

Debridement Services

Debridement Services of Bone, Muscle, Fascia, & Subcutaneous Tissue

Debridement Services of Extensive Eczematous or Infected Skin

Destruction by Neurolytic Agent; Interdigital Nerve of the Foot—Morton’s Neuroma

Destruction of Paravertebral Facet Joint Nerve(s)

DDD

Discography

Distraction Osteosynthesis & Femoral Shortening

Dorsal Column Stimulation

Elbow, Radial

Head Implant

 Elbow, Total Arthroplasty

Endoscopic & Percutaneous Lysis of Epidural Adhesions

Epidural

Excision of Malignant Skin Lesions- Trunk, Arms, or Legs

Extracorporeal Shock Wave Therapy for Musculoskeletal Conditions

Facet Joint Injections, Medial Branch Blocks, & Facet Joint Radiofrequency

Growing Rods for Spinal Surgery

Hammertoe

Repair

Hip, Arthroscopy

Hip

Resurfacing

Hip, Total

(THA)

Hyaluronan Acid Therapies for Osteoarthritis of the Knee

Hyaluronate Polymers

Idiopathic Scoliosis Treatment

Implantable Infusion Pump for the Treatment of Chronic Intractable Pain Opioid

Drugs

Implantable Infusion Pump for the Treatment of Chronic Intractable Spasticity

Injection of Morton's Neuroma

Injection of

Trigger Points

Interspinous Process Decompression

Knee, Arthroscopy

Knee, Arthroscopy-ACL

Knee, Arthroscopy-Chondroplasty

Knee, Arthroscopy-Fat Pad/Plica Resection

Knee, Arthroscopy-Meniscectomy

Knee, Arthroscopy-PCL

Knee, Total

(TKA)

Knee

Unicompartmental

Arthroplasty

Lumbar Spinal Fusion Following Prior Spinal

Surgery

Lumbar Spinal Fusion -

Instability

Fusion for Degenerative Joint Disease of the Lumbar Spine

Lumbar Spinal Fusion for Instability & Degenerative Disc Conditions

Lumbar Spinal Fusion for Instability and Degenerative Disc Conditions-Authorization Required

Lumbar Spinal Fusion for Pseudoarthrosis-Authorization Required

Lumbar Spinal Fusion for Spinal Stenosis-Authorization Required

Elbow

Manipulation Under Anesthesia (MUA)

Knee

Manipulation Under Anesthesia (MUA)

Shoulder

Manipulation Under Anesthesia (MUA)

Metacarpo-phalangeal (MCP)

& Proximal Interphalangeal (PIP) Joint Implants

Metatarsal- phalangeal Joint Replacement

 Nail

Debridement

Nerve Blockade for Treatment of Chronic Pain & Neuropathy

Osteochondral Autografts (Mosaicplasty, OATS)

 Paravertebral Facet Joint

Block

Surgical Correction of Pectus Excavatum & Poland's Syndrome

Pedicle Screws for Spinal Fixation & Intervertebral Body Fusion Devices

Percutaneous Vertebral Augmentation (Vertebral Augmentation) (Formerly Kyphoplasty)

Peripheral

Nerve

Blocks

Pseudoarthrosis

 Sacroiliac Joint Injection

Shoulder Arthrodesis

Shoulder Arthroplasty

Shoulder Arthroplasty Revision

Shoulder Arthroscopy

Shoulder Arthroscopy-Slap Repair or Biceps Tenodesis

Shoulder Arthroscopy-Claviculectomy/Decompresion-Partial Acromioplasty

Shoulder Arthroscopy-Rotator Cuff

Repair

Shoulder - Reverse Arthroplasty

SI Joint Fusion - Medicare

SI Joint Fusion - non-Medicare

Spinal Cord Stimulation (Dorsal Column Stimulation)

Spondylolishthesis

Stenosis

Trigger Point

Injections

Wrist, Total

Arthroplasty