Draft — pending COA review. Rette derived these criteria from the ACOEM guidelines adopted into the MTUS. They are not COA documents and have not been signed off by a COA physician reviewer.

MTUS Treatment ChecklistbyRette

Utilization Review Checklist

Spinal Cord Stimulator for Chronic Cervicothoracic Pain

Derived from the ACOEM Cervical and Thoracic Spine Disorders Guideline, edition 17 October 2018, as adopted into the California MTUS 18 April 2019. CPT 63650, 63655, 63685, 63688. ICD-10 M54.2, M54.6, M54.12, G89.4.

Draft — not reviewed or approved by COA. Prepared by Rette from the ACOEM guideline named above. This is not a COA document and does not reproduce COA’s own checklists.

Patient name: Claim #:

CriteriaCheck if documented

Presumptive Diagnosis(informational — not scored)

Required

  • Chronic cervicothoracic pain, with or without radiculopathy

    Spinal cord stimulators are not recommended for chronic cervicothoracic pain with or without radiculopathy. — p. 116

Procedures — the guideline treats each separately

Implantable spinal cord stimulator for chronic cervicothoracic pain, with or without radiculopathy

Not Recommended. Spinal cord stimulators are not recommended for chronic cervicothoracic pain with or without radiculopathy.

Strength of Evidence — Not Recommended, Insuffcient Evidence (I) · confidence low · p. 116

Indications — required:

  • The guideline advises against spinal cord stimulators for chronic cervicothoracic pain, with or without radiculopathy

    Spinal cord stimulators are not recommended for chronic cervicothoracic pain with or without radiculopathy. — p. 116

Not recommended, with or without radiculopathy. The Low Back chapter's Table 11 selection criteria belong to the lumbar recommendation and are not restated here — but a reviewer may well look for them, so documenting the equivalent is prudent even though this chapter does not ask.

Reviewing this for COA, or think a criterion is wrong?