Musculoskeletal Program: Interventional Pain Management Guideline updates by section:


General Requirements – Conservative Management

  • Addition of physical therapy or home therapy requirement and one complementary modality based on preponderance of benefit over harm to conservative care
  • Align with approach to conservative management defined in spine and joint surgery guidelines


Epidural Injection Procedures and Diagnostic Selective Nerve Root Blocks

  • Addition of statement about adherence to ESI procedural best practices established by FDA Safe Use Initiative. Recommendations are intended for provider education and will not be used for adjudication.
  • Clarification of intent around requirement for advanced imaging for repeat injections


Paravertebral Facet Injection/Nerve Block/Neurolysis

  • Remove indication for 4 unilateral medial branch blocks per session based on panel consensus


Paravertebral Facet Injection/Nerve Block/Neurolysis continued

  • Procedural clarification restricting use of corticosteroids for diagnostic MBB based on panel consensus
  • Limit use of intra-articular steroid injection to mechanical disruption of a facet synovial cyst
  • Remove indication for intra-articular steroid injections based on new evidence for lack of efficacy
  • Increase duration of initial RFN efficacy needed to avoid a MBB to 6 months based on panel consensus
  • Clarification that MBB or RFN is not medically necessary after spinal fusion


Spinal Cord and Nerve Root Stimulators

  • Clarify inclusion of different stimulation methods for spinal cord stimulation
  • Add new indication for dorsal root ganglion stimulation
  • Clarify exclusions for spinal cord and dorsal root ganglion stimulation


As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:

  • Access AIM’s ProviderPortalSM directly at Online access is available 24/7 to process orders in real-time, and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Web Portal at
  • Call the AIM Contact Center toll-free number: 800-554-0580, Monday – Friday,
    8:30 a.m. – 7:00 p.m. ET.


For questions related to guidelines, please contact AIM via email at Additionally, you may access and download a copy of the current and upcoming guidelines here.




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May 2020 Anthem Provider News - Wisconsin