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Vertebral Axial Decompression
Medicare's National Coverage Decision to deny services for Vertebral Axial Decompression (VAX-D) as "not medically necessary" is described in the National Coverage Decision *. However, several local carriers such as Missouri Medicare have published additional instructions regarding VAX-D.
Specifically, Missouri Medicare instructs providers that the following CPT codes are not appropriate to use when reporting axial decompression therapy.
| Do not use the following CPT codes to bill for services when providing services for axial decompression therapy: |
| S9090 |
Vertebral axial decompression, per session |
| 64722 |
Decompression; unspecified nerve(s) (specify) |
| 97012 |
Traction, mechanical |
| 97110 |
Therapeutic exercise |
| 97112 |
Neuromuscular re-education |
| 97140 |
Manual therapy techniques |
| 97530 |
Therapeutic activities |
| 90901 |
Biofeedback training by any modality |
| 97039 |
Unlisted modality |
Action:
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Check your local Medicare carrier and other payors to review updated instructions related to this non-covered service.
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Request patients to sign a Notice of Exclusion of Medicare Benefits (NEMB) explaining Medicare's non coverage policy. Use a similar form for commercial patients when coverage is excluded.
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Report services using the unlisted CPT code 97799-GY. Include the procedure description (Intervertebral Disc Decompression, Axial Decompression) or the name of the device in box 19 or wherever the carrier directs you to.
*Publication 100-03, Chapter 1, Part 2, Section 160.16
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