CMM-606: Lumbar Microdiscectomy (Laminotomy, Laminectomy, or Hemilaminectomy)

Covered: initial and repeat lumbar microdiscectomy (laminotomy/laminectomy/hemilaminectomy) for radiculopathy/neurogenic claudication due to herniated disc, synovial/arachnoid cyst, or central/lateral/foraminal stenosis and for urgent/emergent indications (e.g., cauda equina, progressive neurologic deficit, epidural hematoma, infection, neoplastic compression, severe rapidly progressive motor loss or bowel/bladder dysfunction); laser techniques and percutaneous laser disc decompression are not medically necessary/investigational, and surgery is excluded for isolated axial low back pain, asymptomatic disc bulge without neural impingement, discordant exam/imaging, or sole reliance on discography/MR spectroscopy. Key requirements: concordant advanced imaging and clinical findings with objective exam signs, documentation excluding other pain sources and unmanaged behavioral health disorders, failure of ≥2 conservative therapies unless urgent/emergent, and for repeat procedures >12 weeks since prior surgery with recent (≤6 months) post‑op MRI/CT confirming recurrent neural compression and prior symptom relief (unless imaging shows persistent compression).