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Number 0016 Policy Aetna considers any of the following injections or procedures medically necessary for the treatment of back pain provided however that only one invasive modality or procedure will be considered medically necessary at a time Facet joint injections An initial facet injection (intraarticular and medial branch block) from C23 to L5S1 is considered medically.
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Back Pain Invasive Procedures Medical Clinical Policy
