CMM-308: Intradiscal Procedures

Intradiscal procedures (e.g., IDET, nucleoplasty, coblation percutaneous disc decompression, intradiscal biacuplasty, and intradiscal injections such as methylene blue, hyaluronate, ozone/oxygen, bone marrow concentrate, chymopapain, PRP, mesenchymal stem cells, glucocorticoids, hyaluronidase, growth factors, etc.) are considered experimental, investigational, or unproven and are not supported as established, medically necessary treatments. Requests with atypical presentations require physician review, CPT codes listed are informational only, and coverage/reimbursement and prior authorization are determined by the individual payor so providers should consult the member’s policy and contact the payor.

"Based on the lack of conclusive scientific evidence demonstrating the clinical efficacy of intradiscal procedures and the potential to expose patients to serious adverse side effects or complicatio..."