Medicare WISeR service

Induced Lesions of Nerve Tracts

The current WISeR scope focuses on neurolytic destruction of the trigeminal nerve.

Documentation overview

Documentation categories to review

These categories summarize the approved criteria bundle. The note checker uses the selected state, clinical pathway and procedure details to apply the relevant criteria.

Core documentation

  • Diagnosis and evaluation of trigeminal neuralgia
  • Failure of or intolerance to conventional medications
  • Clinical rationale for rhizotomy or neurolysis over other surgical options

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Educational use only

This page summarizes public CMS documentation criteria. It does not provide medical, legal or coding advice, determine Medicare coverage, predict prior-authorization outcomes, or replace clinical judgment. Coverage decisions are made by CMS and its contractors. Verify the effective policy for the patient’s date and place of service before relying on this summary.