Coverage of Conditions and Treatments (Coverage Decisions)
Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.
List also available in PDF format.
See Treatment Guidelines and Resources for additional information.
L&I or self-insurer covers powered traction therapy administered by a licensed practitioner when powered traction is a proper and necessary treatment. See WAC 296-20-01002 for definitions of proper and necessary medical services.
Scientific literature available at the time of publication has not shown whether powered traction devices are more effective than other forms of traction, other conservative treatments, or surgery.
Powered traction devices are air-powered auto-traction tables, split down the middle to apply cycles of tension axially to the lumbar vertebral column. The tension is intended to unload the spine through decompression. The patient can stop the movement of the table by releasing the handgrips, which stops the tension immediately.
The FDA has approved for marketing several powered traction devices, including:
- DRS System.
- Spina System.
- DRX 2000, 3000, 5000 and 9000.
- Lordex Traction Unit.
Billing and payment
Only 1 unit of the appropriate billing code is paid per visit. L&I and self-insurers do not pay any additional costs when powered traction devices are used.
If you are a board certified/qualified physical medicine physician or a licensed physical therapist:
- Use CPT® 97012 for billing.
Note: All current physical medicine payment policies apply to the use of this code.
If you are not a board certified/qualified physical medicine provider:
- Use local code 1044M for billing.
- The use of this code is limited to 6 times per claim, except when the attending doctor practices in a remote area.
- If the physical modalities are clinically necessary beyond 6 visits, the patient must be referred to a board certified/qualified physical medicine physician or to a licensed physical therapist for such treatment, except when the attending doctor practices in a remote area. See WAC 296-21-290 for more information.
- Cannot use CPT™ codes 97001-97799 for billing.
- If your scope of practice and training is permitted, you may perform physical medicine modalities and procedures described in CPT™ codes 97001-97750 (use 1044M for billing.)
Powered Traction Device technology assessment (45 KB PDF)