24.29.1526 DISALLOWED PROCEDURES
(1) Only reasonable and necessary medical expenses are payable. Procedures that are not generally accepted by the medical community may be determined not to be "reasonable" or "necessary". Providers are encouraged to seek prior approval from the insurer for experimental or controversial procedures.
(3) Medical services which are not payable include, but are not limited to, the following:
(a) disc nucleoplasty;
(b) extreme lateral interbody fusion (XLIA);
(d) frequency specific microcurrent;
(e) HEALOS/leopard cage;
(f) inter X therapy;
(g) kinesis myofascial integration;
(h) lidoderm patch;
(i) percutaneous disc nucleoplasty; and
(j) medical marijuana.