Commercial

Cervical Traction Devices for In-home Use
05.00.61g

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 freestanding 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 7 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


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 September 28, 2020.

Isaac Z. Management of non-radicular neck pain in adults. [UpToDate Web site]. 08/07/2020. Available at: https://www.uptodate.com/contents/management-of-non-radicular-neck-pain-in-adults?search=cervical traction&source=search_result&selectedTitle=2~29&usage_type=default&display_rank=2 [via subscription only].  Accessed September 28, 2020.​

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 September 28, 2020.

Robinson J, Kothari MJ. Treatment and prognosis of cervical radiculopathy. [UpToDate Web site]. 03/23/2020. Available at: https://www.uptodate.com/contents/treatment-and-prognosis-of-cervical-radiculopathy?search=cervical traction&source=search_result&selectedTitle=1~29&usage_type=default&display_rank=1#H10 [via subscription only].  Accessed September 28, 2020.

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
05.00.61
Medical Policy Bulletin
Commercial
No