Orthotrac Pneumatic Vest Medical Policy

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Medica Coverage Policy

https://www.medica.com/-/media/documents/provider/coverage-policies/orthotrac-pneumatic-vest-cp.pdf?la=en&hash=FA7D5BECEF0AB4589633A0B38298907E

The Orthotrac™ Pneumatic Vest is investigative and unproven and therefore NOT COVERED. There is insufficient reliable evidence in the form of high quality peer-reviewed medical literature to establish the efficacy or effects on health care outcomes. Note: This policy is no longer scheduled for routine review of the scientific literature.

Lumbar Traction Devices - Medical Clinical Policy …

https://www.aetna.com/cpb/medical/data/500_599/0569.html

The Orthotrac ™ Pneumatic Vest (Orthofix, Inc., McKinney, TX) is an inflatable pneumatic vest that has been promoted for use in relieving back pain from a variety of causes …

Back Pain - Non Invasive Treatments - Medical Clinical …

https://www.aetna.com/cpb/medical/data/200_299/0232.html

The Orthotrac is an inflatable pneumatic vest that has been used to relieve back pain from a variety of causes (e.g., herniated disc, spinal stenosis, facet syndrome, …

MEDICAL POLICY - LUMBAR TRACTION …

https://www.bcbsm.com/amslibs/content/dam/public/mpr/mprsearch/pdf/2102819.pdf

The Orthotrac™ Pneumatic Vest (Orthofix, Inc., McKinney, TX) is an inflatable pneumatic vest that has been promoted for use in relieving back pain from a variety of causes (e.g., …

Spinal Unloading Devices for Low Back Pain …

https://www.wellcare.com/~/media/PDFs/CCG/EI-CCG/NA_All_CCG_EI_Spinal_Unloading_Devices_eng_09_2018.ashx

The Orthotrac Pneumatic Vest is a custom-made device intended to be worn 2–3 times a day for 30–60 minutes each session. It is a spinal decompression orthotic device that is …

Medica | Coverage Policies for Providers

https://partner.medica.com/providers/policies-and-guidelines/coverage-policies

Coverage policies are developed to communicate Medica decisions about coverage and benefits for various medical services. Each coverage policy contains a description of the …

DME.00025 Self-Operated Spinal Unloading Devices

https://www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_a049576.html

This document addresses self-operated spinal unloading devices, which are designed to support the upper body’s weight and transfer that weight to the hips via a …

Orthotrac Pneumatic Vest - AAPC

https://www.aapc.com/codes/webroot/upload/general_pages_docs/document/o286.pdf

Orthotrac™ Pneumatic Vest is custom made to be worn around the abdominal area. The pneumatic component is manually inflated and is designed to lift the body weight off the …

Thoracic-Lumbo-Sacral Orthosis With Pneumatics

http://www.southcarolinablues.com/web/public/brands/medicalpolicy/external/external-policies/thoracic-lumbo-sacral-orthosis-with-pneumatics/

This medical policy was developed through consideration of peer-reviewed medical literature generally recognized by the relevant medical community, U.S. FDA approval status, …

IBC Medical Policies

https://medpolicy.ibx.com/ibc/Commercial/Pages/PolicyNotification/6a14c096-aade-4eae-8e47-13a6b341a19b.aspx

The intent of this policy is to provide direction for the specific E/I services listed below, that are not spoken to in a specific Company policy. Because unlisted …

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