Medical Policy: 07.01.41
Original Effective Date: May 2008
Reviewed: March 2021
Revised: March 2021
This policy contains information which is clinical in nature. The policy is not medical advice. The information in this policy is used by Wellmark to make determinations whether medical treatment is covered under the terms of a Wellmark member's health benefit plan. Physicians and other health care providers are responsible for medical advice and treatment. If you have specific health care needs, you should consult an appropriate health care professional. If you would like to request an accessible version of this document, please contact customer service at 800-524-9242.
Benefit determinations are based on the applicable contract language in effect at the time the
services were rendered. Exclusions, limitations or exceptions may apply. Benefits may vary
based on contract, and individual member benefits must be verified. Wellmark determines medical
necessity only if the benefit exists and no contract exclusions are applicable. This medical
policy may not apply to FEP. Benefits are determined by the Federal Employee Program.
This Medical Policy document describes the status of medical technology at the time the document
was developed. Since that time, new technology may have emerged or new medical literature may
have been published. This Medical Policy will be reviewed regularly and be updated as scientific
and medical literature becomes available.
Pulsed radiofrequency (PRF) is a non-ablative alternative to non-pulsed or continuous radiofrequency ablation (RFA) in the treatment of various chronic pain syndromes. Pulsed radiofrequency is delivered in short bursts, twice per second, followed by a quiet phase in which no current is applied. This allows for cooling of the electrode keeping it below the neurodestructive threshold of 45°C. Since the average temperature does not reach the neurodestructive range, the risk of destroying nearby tissue is reduced. Pulsed radiofrequency has been proposed as a possibly safer alternative to non-pulsed or continuous RFA.
Pulsed radiofrequency has been used in the treatment of peripheral neuropathies, arthrogenic pain, painful trigger points, radiculopathy and many other chronic pain syndromes. Unlike known side effects of continuous radiofrequency such as, neuritis-like reactions, motor deficits, and the risk of deafferentiation pain syndrome, pulsed radiofrequency seems to have few side effects and is seen as relatively safe. However, even though there is much anecdotal evidence which favors the use of pulsed radiofrequency for the use of pain relief without nervous tissue damage, especially in the treatment of neuropathic pain, there is a lack of randomized controlled trials (RCTs) substantiating its efficacy.
Summary of Evidence
For individuals with various chronic pain syndromes, especially neuropathic pain who received pulsed radiofrequency, the evidence includes a small number of RCTs, non-randomized controlled trials, prospective uncontrolled trials, retrospective studies, case series, and case reports. The majority of the uncontrolled and observational studies reported clinical efficacy of pulsed radiofrequency, however many of these studies had limitations. The controlled clinical data is limited and with inconsistent findings. Further research in the clinical and biological effects of pulsed radiofrequency is needed including well-designed, randomized controlled clinical trials with a large sample size and long-term follow-up to determine the therapeutic effect and safety of this treatment modality. There is also a lack of data comparing pulsed radiofrequency with conventional treatments. As such, it is unknown if pulsed radiofrequency offers any treatment advantage over other conventional treatments. The evidence is insufficient to determine the effects of the technology on health outcomes.
A number of radiofrequency generators and probes have been cleared for marketing through the U.S. Food and Drug Administration (FDA) 510(k) process.
Practice Guidelines and Position Statements
American Society of Interventional Pain Physicians
In 2013, American Society of Interventional Pain Physicians (ASIPP) published an updated guideline on interventional techniques in the management of chronic spinal pain Part II guidance and recommendation which states the following:
- Lumbar spine
- The evidence for therapeutic facet joint interventions is good for conventional radiofrequency, limited for pulsed radiofrequency, fair to good for lumbar facet joint nerve blocks, and limited for intraarticular injections.
- For sacroiliac interventions, the evidence for cooled radiofrequency neurotomy is fair; limited for intraarticular injections and periarticular injections; and limited for both pulsed radiofrequency and conventional radiofrequency neurotomy.
- Cervical Spine
- Evidence for therapeutic facet joint intervention is faire for conventional cervical radiofrequency neurotomy.
- Thoracic Spine
- Evidence is limited for radiofrequency neurotomy.
See Related Medical Policies:
- 07.01.58 Facet Joint Denervation*
- 07.01.66 Ablative Treatments for Occipital Neuralgia, Chronic Headaches and Atypical Facial Pain*
- 07.01.73 Ablative Procedures of the Peripheral Nerves to Treat Pain*
Pulsed radiofrequency is considered investigational in the treatment of various chronic pain syndromes including but not limited to the following, as the evidence is insufficient to determine the effects of the technology on net health outcomes:
- Chronic head and facial pain (persistent idiopathic facial pain (PIFP)/atypical facial pain/spheno-palatine ganglion)
- Complex regional pain syndrome/reflex sympathetic dystrophy
- Diabetic peripheral neuropathy
- Discogenic pain
- Facet joint pain cervical, lumbar and thoracic/Zygapophyseal joint pain
- Headaches (including but not limited to the following: chronic headaches; cervicogenic headaches; migraines; cluster headaches; tension headaches)
- Inguinal neuralgia
- Intercostal neuralgia
- Low back pain
- Lumbo-sacral radicular syndrome (e.g. dorsal root ganglion)
- Meralgia paresthetica (burning pain in the outer thigh related to lateral femoral cutaneous nerve entrapment)
- Metacarpal or metatarsal joint pain of the hands and feet
- Morton’s neuroma
- Myofacial pain syndrome
- Neck pain (cervical pain)
- Occipital neuralgia
- Ophthalmic neuralgia
- Orchalgia (testicular pain)
- Osteoarthritis of hip/chronic hip pain to include pain management of a previous total hip arthroplasty
- Osteoarthritis of knee/chronic knee pain to include pulsed radiofrequency of genicular nerve for the treatment of chronic knee pain due to osteoarthritis (severe degenerative disease) or previous total knee arthroplasty
- Peripheral neuromas
- Pelvic pain
- Piriformis syndrome (buttock pain and/or pain in the back of the lower extremity related to sciatic nerve irritation)
- Plantar fasciitis
- Post-herpetic neuralgia
- Pudenal neuralgia
- Refractory ventricular arrhythmias
- Sacro-iliac joint pain
- Shoulder pain (suprascapular nerve)
- Tarsal tunnel syndrome (compression neuropathy from entrapment of the posterior tibial nerve)
- Thoracic pain
- Trigeminal neuralgia
Procedure Codes and Billing Guidelines:
To report provider services, use appropriate CPT* codes, Modifiers, Alpha Numeric (HCPCS level 2) codes, Revenue codes, and/or ICD diagnosis codes
- 64999 Unlisted procedure, nervous system (The American Medical Association’s CPT Editorial Panel decided in June 2005 that the unlisted CPT code 64999 should be used for pulsed radiofrequency treatment as opposed to other specific codes)
- Cahana A, Van Zundert J, Macrea L et al. Pulsed radiofrequency: current clinical and biological literature available. Pain Med. 2006 Sep-Oct;7(5):411-23.
- Lindner R, Sluijter ME, Schleinzer W. Pulsed radiofrequency treatment of the lumbar medial branch for facet pain: a retrospective analysis. Pain Med. 2006 Sep-Oct;7(5):435-9.
- Tekin I, Mirzai H, Ok G et al. A comparison of conventional and pulsed radiofrequency denervation in the treatment of chronic facet joint pain. Clin J Pain. 2007 Jul-Aug;23(6):524-9.
- Van Zundert J, Patijun J, Kessels A et al. Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: a double blind sham controlled randomized trial. Pain. 2007 Jan;127(1-2):173-82. Comment in: Expert Rev Neurother. 2007 May;7(5):471-2. Pain. 2007 Jan;127(1-2):3-4.
- Boswell MV, Trescot AM, Datta S et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007 Jan;10(1):7-111.
- Simopolous TT, Kraemer J, Nagda JV et al. Response to pulsed and continuous radiofrequency lesioning of the dorsal root ganglion and segmental nerves in patients with chronic lumbar radicular pain. Pain Physician. 2008 Mar;11(2):137-44.
- Luleci N, Ozdemir U, Dere K et al. Evaluation of patients’ response to pulsed radiofrequency treatment applied to the suprascapular nerve in patients with chronic shoulder pain. J Back Musculoskelet Rehabil. 2011 Jan 1; 24(3):189-94.
- Van Boxem K, van Bilsen J, de Meij N et al. Pulsed radiofrequency treatment adjacent to the lumbar dorsal root ganglion for the management of lumbosacral radicular syndrome: a clinical audit. Pain Med. 2011 Aug 3. doi:10.1111/j.1526-4637.2011.01202.x. [Epub ahead of print].
- Nagda JV, Davis CW, Bajwa ZH et al. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain. Pain Physician. 2011 Jul-Aug; 14(4):371-6.
- Todorov L. Pulsed radiofrequency of the sural nerve for the treatment of chronic ankle pain. Pain Physician. 2011 May-Jun; 14(3):301-4.
- Korkmaz OK, Capaci K, Eyigor C et al. Pulsed radiofrequency versus conventional transcutaneous electrical nerve stimulation in painful shoulder: a prospective, randomized study. Clin Rehabil. 2010 Nov; 24(11):1000-8. Epub 2010 Aug 4.
- Taverner MG, Ward TL, Loughnan TE. Transcutaneous pulsed radiofrequency treatment in patients with painful knee awaiting total knee joint replacement. Clin J Pain. 2010 Jun;26(5):429-32.
- Eyigor C, Eyigor S, Korkmaz OK et al. Intra-articular corticosteroid injections versus pulsed radiofrequency in painful shoulder: a prospective, randomized, single-blinded study. Clin J Pain. 2010 Jun;26(5):386-92.
- Vanelderen P, Rouwette T, De Vooght P et al. Pulsed radiofrequency for the treatment of occipital neuralgia: a prospective study with 6 months of follow-up. Reg Anesth Pain Med. 2010 Mar-Apr; 35(2):148-51.
- Hansen H, Manchikanti L, Simopoulos TT et al. A systematic evaluation of the therapeutic effectiveness of sacroiliac joint interventions. Pain Physician. 2012 May-Jun; 15(3):E247-78.
- Gofeld M, Restrepo-Garces CE, Theodore BR et al. Pulsed radiofrequency of suprascapular nerve for chronic shoulder pain: a randomized double-blind active placebo-controlled study. Pain Pract. 2012 May 4. doi: 10.1111/j.1533-2500.2012.00560.x. [Epub ahead of print]
- Guo L, Kubat NJ, Nelson TR et al. Meta-analysis of clinical efficacy of pulsed radiofrequency energy treatment. Ann Surg. 2012 Mar; 255(3):457-67.
- Conner-Kerr T, Isenberg RA. Retrospective analysis of pulsed radiofrequency energy therapy use in the treatment of chronic pressure ulcers. Adv Skin Wound Care. 2012 Jun;25(6):253-60.
- Choi GS, Ahn SH, Cho YW et al. Short-term effects of pulsed radiofrequency on chronic refractory cervical radicular pain. Ann Rehabil Med. 2011 Dec;35(6):826-32. Epub 2011 Dec 30.
- Fukui S, Rohof O. Results of pulsed radiofrequency technique with two laterally placed electrodes in the annulus in patients with chronic lumbar discogenic pain. J Anesth. 2012 Aug;26(4):606-9. Epub 2012 Apr 5.
- Nagda JV, Davis CW, Bajwa ZH et al. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain. Pain Physician. 2011 Jul-Aug;14(4):371-6.
- Werner MU, Bischoff JM, Rathmell JP et al. Pulsed radiofrequency in the treatment of persistent pain after inguinal herniotomy: a systematic review. Reg Anesth Pain Med. 2012 May-Jun;37(3):340-3.
- Zhang J, Shi DS, Wang R. Pulsed radiofrequency of the second cervical ganglion (C2) for the treatment of cervicogenic headache. J Headache Pain. 2011 Oct;12(5):569-71. Epub 2011 May 25.
- Manchikanti L, Abdi S et al. An update of comprehensive evidence-based guidelines for interventional techniques in chronic spinal pain. Part II. Pain Physician 2013 Apr; 16: S49-283.
- American Society of Anesthesiologists. Practice Guidelines for Chronic Pain Management: An Updated Report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology April 2010; 112: 1-1.
- National Institute of Health. NIH Public Access. Pulsed Radiofrequency for Chronic Pain, David Byrd M.D., MPH and Sean Mackey, M.D., PhD. January 2008; 12(1):37-41.
- Medscape Radiofrequency Therapies in Chronic Pain.
- Practical Pain Management Use of Pulsed Radiofrequency in Clinical Practice.
- Journal of Pain Research: Treatment of Trigeminal Neuralgia: Role of Radiofrequency Ablation. J Pain Res. 2010; 3:249-254. Published online December 12, 2010 doi:10.2147/JPRS14455
- PubMed. 3D-CT Guided Pulsed Radiofrequency Treatment for Trigeminal Neuralgia. Pain Practice.2014 Jan; 14(1):16-21. doi: 10.1111/papr.12041. Epub2013 Feb 21.
- Matthew David VanderHoek, Hieu T. Hoang, Brandon Goff, Ultrasound Guided Greater Occipital Nerve Blocks and Pulsed Radiofrequency Ablation for Diagnosis and Treatment of Occipital Neuralgia. Anesthesiology and Pain Medicine. 2013 September; 3(2):256-9.
- American Society of Interventional Pain Physicians (ASIPP). An Update of Comprehensive Evidence Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part II: Guidance and Recommendations. Pain Physicians 2013; 16:S49-S283 ISSN 1533-3159.
- American Pain Society. Guideline for Evaluation and Management of Low Back Pain, Evidence Review 2009.
- American Academy of Pain Medicine. Pulsed Radiofrequency Lesioning of Pudendal Nerve in Patient with Chronic Pain: A Case Report 2012.
- Pain Medicine News. Evidence Based Review of Radiofrequency Ablation Techniques for Chronic Sacroiliac Joint Pain.
- Pain Medicine News Special Edition December 2013, Pulsed Radiofrequency in Treatment of Peripheral Neuralgias
- Nicholas Manolitsis, M.D., Foad Elahi, M.D., Pulsed Radiofrequency for Occipital Neuralgia, Pain Physician 2014; 17:E709-E717.
- Slavin Konstantin, Nersesyan Hrachya et. al. Current Algorithm for the Surgical Treatment of Facial Pain, Head and Face Medicine July 2007
- American Society of Anesthesiologists and American Society of Regional Anesthesia and Pain Medicine, Practice Guideline for Chronic Pain Management, Anesthesiology 2010 Vol 112. No 4
- Medscape Radiofrequency Treatment in Chronic Pain, Expert Rev Neurother 2010;10(3):469-474.
- Akbas Mert Gunduz Emel, et.al. Sphenopalatine Ganglion Pulsed Radiofrequency Treatment in Patients Suffering from Chronic Face and Head Pain, April 2014
- Cohen S, Peterlin LB, Fulton L, et. al. Randomized, double-blind, comparative-effectiveness study comparing pulsed radiofrequency to steroid injections for occipital neuralgia or migraine with occipital nerve tenderness. Pain 2015 December; 156(12):2585-2594
- Taverner MG, Ward TL, Loughnan TE. Transcutaneous pulsed radiofrequency treatment in patients with painful knee awaiting total knee joint replacement. Clin J Pain. 2010;26(5):429-432
- Chua NH, Vissers KS, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications – a review. Acta Neurochir (Wien). 2011 Apr 153(4):763-71
- Zakrzewska JM. Akram H. Neurosurgical interventions for the treatment of classical trigeminal neuralgia. Cochrane Database Syst Rev 2011 Sep 7(9): CD007312. PMID 21901707
- Taverner MG, Loughnan TE, Soon CW. Transcutaneous application of pulse radiofrequency treatment for shoulder pain. Pain Pract 2013 Apr 13(4):310-5
- Nagar VR, Birthi P, Grider JS, Asopa A. Systematic review of radiofrequency ablation and pulsed radiofrequency for management of cervicogenic headache. Pain Physician 2015 Mar-Apr 18(2):109-30. PMID 25794199
- van Boxem K, van Bilsen J, de Meij N, et. al. Pulsed radiofrequency treatment adjacent to the lumbar dorsal root ganglion for the management of lumbosacral radicular syndrome: A clinical audit. Pain Medicine 2011;12: 1322-1330
- Shanthanna H, Chan P, McChesney J, et. al. Pulsed radiofrequency treatment of the lumbar dorsal root ganglion in patients with chronic lumbar radicular pain: a randomized, placebo-controlled pilot study. Journal of Pain Research 2014:7 47-55
- Manolitsis N, Elahi F. Pulsed Radiofrequency for Occipital Neuralgia. Focused Review. Pain Physician 2014; 17: E709-E717
- Ke M, Yinghui F, Yi J, et. al. Efficacy of pulsed radiofrequency in the treatment of thoracic postherpatic neuralgia from the angulus costae: A randomized double blinded, controlled trial. Pain Physician 2013; 16:15-25
- Schianchi P, Sluijter M, Balogh S. The treatment of joint pain with intra-articular pulsed radiofrequency. Anesthesiology and Pain Medicine 2013 September;3(2):250-5
- Guo J, Dong X, Zhao X. Treatment of trigeminal neuralgia by radiofrequency of the Gasserian ganglion. Rev Neurosci 2016 Oct 1:27(7):739-743. PMID 27383870
- Hayase J, Vampola S, Ahadian F. et. la. Comparative efficacy of stellate ganglion block with bupivacaine vs pulsed radiofrequency in a patient with refractory ventricular arrhythmias. J Clin Anesth Jun 31;162-5. PMID 27185701
- Bhatia A, Peng P, Cohen SP. Radiofrequency procedures to relieve chronic knee pain: An evidence based narrative review. Reg Anesth Pain Med 2016 Jul-Aug;41(4):501-10. PMID 27281721
- Deniz S, Purtuloglu T, Tekindur S, et. al. Ultrasound guided pulsed radiofrequency treatment in Morton’s neuroma. J Am Podiatr Med Assoc 2015 Jul;105(4):302-6. PMID 25945935
- Makharita MY, Amr YM. Pulsed radiofrequency for chronic inguinal neuralgia. Pain Physician 2015 Mar-Apr;18(2):E147-55. PMID 25794213
- Nagar VR, Birthi P, Grider JS, et. al. Systematic review of radiofrequency ablation and pulsed radiofrequency for management of cervicogenic headache. Pain Physician 2015 Mar-Apr;18(2):109-30. PMID 25794199
- Kesikburun S, Yasar E, Uran A, et. al. Ultrasound guided genicular nerve pulsed radiofrequency treatment for painful knee osteoarthritis: A preliminary report. Pain Physician 2016;19:E751-E759.
- Naderi-Nabi B, Sedighinejad A, Haghighi M, et. al. Comparison of transcutaneous electrical nerve stimulation and pulsed radiofrequency sympathectomy for treating painful diabetic neuropathy. Anesth Pain Med 2015 October; 5(5):e29280
- Schianchi P. A new technique to treat facet joint pain with pulsed radiofrequency. Anesth Pain Med 2015 February; 5(1): e21061
- Akbas M, Gunduz E, Sanli S, et. al. Sphenopalatine ganglion pulsed radiofrequency treatment in patients suffering from chronic face and head pain. Bras Anestesiol vol. 66 no. 1 Campinas Jan/Feb 2016
- Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: Mechanisms and potential indications-a review. Acta Neurochir (Wien). 2011;153(4):763-771. PMID 21116663
- Choi HJ, Oh IH, Choi SK, Lim YJ. Clinical outcomes of pulsed radiofrequency neuromodulation for the treatment of occipital neuralgia. J Korean Neurosurg Soc. 2012;51(5):281-285. PMID 22792425
- Bui C, Pangarkar S, Zeitlin SI. Relief of urinary urgency, hesitancy, and male pelvic pain with pulse radiofrequency ablation of the pudendal nerve: A case presentation. Case Rep Urol. 2013;2013:125703. PMID 23607041
- Fang L, Ying S, Tao W, et al. 3D CT-guided pulsed radiofrequency treatment for trigeminal neuralgia. Pain Pract. 2014;14(1):16-21. PMID 23433058
- Kestranek J, Spacek J, Ryska P, et al. Radiofrequency therapy for severe idiopathic vulvodynia. J Low Genit Tract Dis. 2013;17(4):e1-e4. PMID 23903198
- Terkawi AS, Romdhane K. Ultrasound-guided pulsed radiofrequency ablation of the genital branch of the genitofemoral nerve for treatment of intractable orchalgia. Saudi J Anaesth. 2014;8(2):294-298. PMID 24843352
- Thapa D, Ahuja V. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality. Indian J Anaesth. 2014;58(2):183-185. PMID 24963184
- Park HG, Park PG, Kim WJ, et al. Ultrasound-assisted mental nerve block and pulsed radiofrequency treatment for intractable postherpetic neuralgia: Three case studies. Korean J Pain. 2014;27(1):81-85. PMID 24478907
- Eyigor C, Eyigor S, Akdeniz S, Uyar M. Effects of intra-articular application of pulsed radiofrequency on pain, functioning and quality of life in patients with advanced knee osteoarthritis. J Back Musculoskelet Rehabil. 2015;28(1):129-134. PMID 25061031
- Chon JY, Hahn YJ, Sung CH, et al. Pulsed radiofrequency under ultrasound guidance for the tarsal tunnel syndrome: Two case reports. J Anesth. 2014;28(6):924-927. PMID 24728720
- Ding DF, Li RC, Xiong QJ, et al. Pulsed radiofrequency to the great occipital nerve for the treatment of intractable postherpetic itch: A case report. Int J Clin Exp Med. 2014;7(10):3497-3500. PMID 25419389
- kbas M, Gunduz E, Sanli S, Yegin A. Sphenopalatine ganglion pulsed radiofrequency treatment in patients suffering from chronic face and head pain. Rev Bras Anestesiol. 2016;66(1):50-54. PMID 26768930
- Gulati A, Shah R, Puttanniah V, et al. A retrospective review and treatment paradigm of interventional therapies for patients suffering from intractable thoracic chest wall pain in the oncologic population. Pain Med. 2015;16(4):802-810. PMID 25236160
- De Andres J, Sanchis-Lopez N, Asensio-Samper JM, et al. Vulvodynia -- An evidence-based literature review and proposed treatment algorithm. Pain Pract. 2016;16(2):204-236. PMID 25581081
- Guo J, Dong X, Zhao X. Treatment of trigeminal neuralgia by radiofrequency of the Gasserian ganglion. Rev Neurosci. 2016;27(7):739-743. PMID 27383870
- Osman AM, El-Hammady DH, Kotb MM. Pulsed compared to thermal radiofrequency to the medial calcaneal nerve for management of chronic refractory plantar fasciitis: A prospective comparative study. Pain Physician. 2016;19(8):E1181-E1187. PMID 27906949
- Bhatjiwale MG, Bhatjiwale MM, Bhagat A. Ultra-extended euthermic pulsed radiofrequency for the treatment of ophthalmic neuralgia: A case report with elaboration of a new technique. Surg Neurol Int. 2016;7(Suppl 35):S818-S823. PMID 27990312
- Lee JJ, Sohn JH, Choi HJ, et al. Clinical efficacy of pulsed radiofrequency neuromodulation for intractable meralgia paresthetica. Pain Physician. 2016;19(3):173-179. PMID 27008291
- Gupta A, Huettner DP, Dukewich M. Comparative effectiveness review of cooled Versus pulsed radiofrequency ablation for the treatment of knee osteoarthritis: A systematic review. Pain Physician. 2017;20(3):155-171. PMID 28339430
- Weiss AL, Ehrhardt KP, Tolba R. Atypical facial pain: A comprehensive, evidence-based review. Curr Pain Headache Rep. 2017;21(2):8. PMID 28251523
- Cho IT, Cho YW, Kwak SG, Chang MC. Comparison between ultrasound-guided interfascial pulsed radiofrequency and ultrasound-guided interfascial block with local anesthetic in myofascial pain syndrome of trapezius muscle. Medicine (Baltimore). 2017;96(5):e6019. PMID 28151904
- Apiliogullari S, Gezer IA, Levendoglu F. Transient sensory recovery in stroke patients after pulsed radiofrequency electrical stimulation on dorsal root ganglia: A case series. Neurologist. 2017;22(1):18-20. PMID 28009767
- Facchini G, Spinnato P, Guglielmi G, et al. A comprehensive review of pulsed radiofrequency in the treatment of pain associated with different spinal conditions. Br J Radiol. 2017;90(1073):20150406. PMID 28186832
- Basal S, Ergin A, Yildirim I, et. al. A novel treatment of chronic orchialgia. J Androl. 2012;33(1):22-26
- Chen Y, Huang-Lionnet JHY, Cohen SP. Radiofrequency ablation in coccydynia: A case series and comprehensive, evidence-based review. Pain Med 2017;18(6):1111-1130
- Gofeld M, Restrepo-Garces CE, Theodore BR et. al. Pulsed radiofrequency of suprascapular nerve for chronic shoulder pain: a randomized double-blind active placebo-controlled study. Pain Pract. 2012 May 4
- Park SM, Cho YW, Ahn SH, et. al. Comparison of the effects of ultrasound-guided interfascial pulsed radiofrequency and ultrasound-guided interfascial injection on myofacial pain syndrome of the gastrocnemius. Ann Rehabil Med 2016;40(5):885-892
- Grandhi RK, Kaye AD, Abd-Elsayed A et. al. Systematic review of radiofrequency ablation and pulsed radiofrequency for management of cervicogenic headaches. Curr Pain Headache Rep. 2018;22(3):18. PMID: 29476360
- Hetta DF, Mahran AM, Kamal EE et. al. Pulsed radiofrequency treatment for chronic post-surgical orchialgia: A double-blind, sham controlled,randomized trial: Three-month results. Pain Physician. 2018;21(2):199-205. PMID: 29565950
- Picelli A, Lobba D, Vendramin P, et al. A retrospective case series of ultrasound-guided suprascapular nerve pulsed radiofrequency treatment for hemiplegic shoulder pain in patients with chronic stroke. J Pain Res. 2018;11: 1115- 1120. PMID 29942146
- Contreras Lopez WO, Navarro PA, Vargas MD, et al. Pulsed radiofrequency versus continuous radiofrequency for facet joint low back pain: A systematic review. World Neurosurg. 2019; 122:390-396. PMID: 30404055
- Erdem Y, Sir E. The efficacy of ultrasound-guided pulsed radiofrequency of genicular nerves in the treatment of chronic knee pain due to severe degenerative disease or previous total knee arthroplasty. Med Sci Monit. 2019; 25:1857-1863.PMID: 30858350
- Jia Y, Pan Y, Ren H, et al. Effectiveness and safety of high-voltage pulsed radiofrequency to treat patients with primary trigeminal neuralgia: A multicenter, randomized, double-blind, controlled study protocol. Pain Physician. 2018;21(5):469-481. PMID: 30282391
- Li X, Zhang L, Gu S, et al. Comparative effectiveness of extracorporeal shock wave, ultrasound, low-level laser therapy, noninvasive interactive neurostimulation, and pulsed radiofrequency treatment for treating plantar fasciitis: A systematic review and network meta-analysis. Medicine (Baltimore). 2018;97(43): e12819. PMID: 30412072
- March 2021 - Annual Review, Policy Revised
- March 2020 - Annual Review, Policy Revised
- March 2019 - Annual Review, Policy Revised
- March 2018 - Annual Review, Policy Revised
- March 2017 - Annual Review, Policy Revised
- March 2016 - Annual Review, Policy Revised
- October 2015 - Interim Review, Policy Revised
- April 2015 - Annual Review, Policy Renewed
- May 2014 - Annual Review, Policy Revised
- August 2013 - Annual Review, Policy Renewed
- September 2012 - Annual Review, Policy Renewed
- September 2011 - Annual Review, Policy Renewed
Wellmark medical policies address the complex issue
of technology assessment of new and emerging treatments, devices,
drugs, etc. They are developed to
assist in administering plan benefits and constitute neither offers of
coverage nor medical advice. Wellmark medical policies contain only a
partial, general description of plan or program benefits and do not
constitute a contract. Wellmark does not provide health care services
and, therefore, cannot guarantee any results or outcomes.
Participating providers are independent contractors in private
practice and are neither employees nor agents of Wellmark or its
affiliates. Treating providers are solely responsible for medical
advice and treatment of members. Our medical policies may be updated
and therefore are subject to change without notice.
*CPT® is a registered trademark of the American Medical Association.