HCPCS Code S9090: Vertebral axial decompression

Struggling with S9090 claims? Learn documentation, modifiers, and payer rules for vertebral axial decompression therapy billed per session.

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Frequently asked questions

Medicare generally does not cover S9090, and many MAC policies categorize vertebral axial decompression as investigational in the absence of a specific National Coverage Determination. When Medicare coverage is not available, practices often consider alternative coding such as 97012 when criteria are met or obtain an ABN when providing a noncovered service.

There is no single CPT code for branded decompression systems. Many payers direct providers to CPT 97012 for mechanical traction when the service meets that definition, while others consider device-specific vertebral axial decompression therapy non-covered and require prior authorization or deny the claim.

Evidence is mixed. While some reports describe pain relief, multiple reviews cite insufficient evidence in high-quality peer-reviewed medical literature that DRX-type systems outperform standard physical therapy or conventional traction for chronic back pain and radiculopathy. Coverage decisions often reflect this uncertainty.