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Cervical Traction Devices for In-home Use
05.00.61g

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Policy

NOT MEDICALLY NECESSARY

The following types of cervical traction devices for home use are considered not medically necessary and, therefore, not covered because the available published peer-reviewed literature does not support their use in the diagnosis or treatment of illness or injury.
  • Cervical traction using a mechanical device or pneumatic device
  • Cervical traction applied via attachment to a headboard or a free-standing frame 
  • Inflatable cervical traction devices

Guidelines

BENEFIT APPLICATION

Subject to the terms and conditions of the applicable benefit contract, cervical traction for in-home use is not eligible for payment under the medical benefits of the Company’s products because the service is considered not medically necessary and, therefore, not covered.

Description

Cervical traction is commonly performed to relieve muscle spasms in the neck and shoulders, and to relieve the pain of pinched nerves in the neck. It can be administered by various techniques ranging from supine mechanical motorized or pneumatic traction, to seated traction using over-the-door pulleys with attached weights.

A Cochrane collaboration systematic review of seven randomized controlled trials (n=958) by Graham et al. (2011) assessed the effects of mechanical traction for neck disorders. Outcomes included pain, function, disability, global perceived effect, patient satisfaction, and quality of life measures. The review found no statistically significant difference between continuous traction and placebo traction in reducing pain or improving function for chronic neck disorders. The authors concluded that there was no evidence to clearly support or refute the use of either continuous or intermittent traction for neck disorders. Further studies are needed to assess the safety and efficacy of traction for neck disorders.

References

Bier JD, Scholten-Peeters WGM, Staal JB, et al. Clinical practice guideline for physical therapy assessment and treatment in patients with non-specific neck pain. Physical Therapy. 2018;98(3):162-171.


Colombo C, Salvioli S, Gianola S, et al. Traction therapy for cervical radicular syndrome is statistically significant but not clinically relevant for pain relief. A systematic literature review with meta-analysis and trial sequential analysis. J Clin Med. 2020;9(11):3389.


Graham N, Gross A, Goldsmith CH, et al. Mechanical traction for neck pain with or without radiculopathy [Abstract]. Cochrane Database Syst Rev. 2008;Jul 16;(3):CD006408. Available at: https://www.ncbi.nlm.nih.gov/pubmed/18646151. Accessed February 7, 2023.


Isaac Z. Management of non-radicular neck pain in adults. [UpToDate Web site]. 11/16/2021. Available at https://www.uptodate.com/contents/management-of-non-radicular-neck-pain-in-adults?search=Isaac Z. Management of non-radicular neck pain in adults. &source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3 [via subscription only].  Accessed February 7, 2023.


Kothari MJ, Chuang K. Treatment and prognosis of cervical radiculopathy. [UpToDate Web site]. 01/17/2023. Available at: https://www.uptodate.com/contents/treatment-and-prognosis-of-cervical-radiculopathy?search=robinson j kothari mj treatment and prognosis of cervical radiculopathy&source=search_result&selectedTitle=1~92&usage_type=default&display_rank=1​ [via subscription only]. Accessed February 7, 2023.

Lahu N, Miftari S, Latifi-Lahu V. The influence of the cervical traction and manipulative methods in a report with chronic neck pain. Research in Physical Education, Sport and Health. 2019;8(1):85-88.


North American Spine Society (NASS). Clinical guideline: Diagnosis and treatment of cervical radiculopathy from degenerative disorders. 2010. Available at: https://www.spine.org/ResearchClinicalCare/QualityImprovement/ClinicalGuidelines.aspx. Accessed February 7, 2023.


Xiao LX, Liu CS, Zhong SZ, Huang WH. Effect of a traction exercise neck brace on cervical spondylopathy radiculopathy: A clinical study and finite element analysis. Evid Based Complement Alternat Med. 2021;2021:8825150.

Yang JD, Tam KW, Huang TW. Intermittent cervical traction for treating neck pain: a meta-analysis of randomized controlled trials. Spine. 2017;42(13):959-965.

Young IA, Michener LA, Cleland JA, et al. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Phys Ther. 2009;89(7):632-42. Epub 2009 May 21. Erratum in: Phys Ther. 2009;89(11):1254-5. Phys Ther. 2010;90(5):825.​

Coding

CPT Procedure Code Number(s)
N/A
ICD - 10 Procedure Code Number(s)
N/A
ICD - 10 Diagnosis Code Number(s)
N/A
HCPCS Level II Code Number(s)
E0840 Traction frame, attached to headboard, cervical traction

E0849 Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible

E0850 Traction stand, freestanding, cervical traction

E0855 Cervical traction equipment not requiring additional stand or frame

E0856 Cervical traction device, with inflatable air bladder(s)

E0860 Traction equipment, overdoor, cervical
Revenue Code Number(s)
N/A



Coding and Billing Requirements

Policy History

11/9/2020
11/9/2020
3/22/2023
05.00.61
Medical Policy Bulletin
Commercial
No
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