SURG.00052 Percutaneous Vertebral Disc Procedures

This policy addresses percutaneous vertebral disc procedures, specifically percutaneous intradiscal electrothermal therapy (IDET), intradiscal radiofrequency thermocoagulation, and intradiscal biacuplasty for discogenic low back pain and related disc disease. Anthem deems these procedures investigational/experimental and not medically necessary; there are no covered indications, and they are not covered for any condition (including chronic low back pain or disc herniation). Noncoverage applies to services billed under CPT/HCPCS codes 22526, 22527, 22899, 64628, 64629, 64999, C9752, C9753, S2370, and S2371.

"The following procedures are consideredinvestigational and not medically necessary:"

Sign up to see full coverage criteria, indications, and limitations.