Diagnosis: Low back pain
Treatment: Radiofrequency ablation
The proposed treatment is medically necessary.

The patient is a female with low back pain who underwent right lumbar radiofrequency ablation (RFA).

According to the attached documentation, the patient is a female with axial low back pain. The patient has failed conservative treatment for over one year which included physical therapy. A magnetic resonance image (MRI) report was attached in the additional information. There is no severe stenosis. In addition, it is reported that the patient had over 80% relief with the medial branch blocks prior to radiofrequency ablation. Given the above, the requested radiofrequency ablation was medically necessary.