Is Rhizotomy Covered Under The New York State Workers’ Compensation Board’s Medical Treatment Guidelines?

A Rhizotomy procedure is covered under the New York State Workers’ Compensation Board’s Medical Treatment Guidelines.  Section D.11 is the pertinent section and recommends this treatment as “a last resort” in patients with chronic back pain.

If a patient has received relief from a facet joint injection, a Rhizotomy may be indicated.

Because this procedure is not listed in Section A.14, it does not appear to require pre-authorization.  As such, if the treating physician has review the Guidelines and feels that the patient’s circumstance fits within them, they may schedule the procedure and can expect to receive payment from the insurance carrier without the delays of securing a variance or prior authorization.