G2138 Insurance Policy Changes

HCPCS G2138 is officially defined as "Back pain as measured by the visual analog scale (vas) or numeric pain scale at one year (9 to 15 months) postoperatively was less than or equal to 3.0 or back pain measured by the visual analog scale (vas) or numeric pain scale within three months preoperatively and at one year (9 to 15 months) postoperatively demonstrated an improvement of 5.0 points or greater." HCPCS G2138 is referenced in 1 tracked payer policy change from Sentara Health Plans. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS G2138 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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