Payer PolicyActive
CMM-308: Thermal Intradiscal Procedures
EVICORE-MSK_ADVANCED-A73AD037
EviCore by Evernorth
Effective: February 15, 2019
Updated: January 13, 2026
created · Dec 5, 2025
Policy Summary
Thermal intradiscal procedures (e.g., IDET, IDB/biacuplasty, Nucleoplasty, PIRFT, Disc-FX, coblation/PDD, etc.) are considered not medically necessary and therefore not covered due to lack of conclusive evidence and potential serious adverse effects. No covered indications, frequency/age/other criteria, or documentation requirements are provided; CPT codes are listed for informational purposes only and preauthorization requirements vary by payer.
Coverage Criteria Preview
Key requirements from the full policy
"None. Thermal intradiscal procedures are considered not medically necessary (see Non-indications)."
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