CMM-308: Thermal Intradiscal Procedures

Thermal intradiscal procedures — including IDET, intradiscal biacuplasty, nucleoplasty/Disc‑FX, coblation percutaneous disc decompression, PIRFT and other listed thermal annuloplasty techniques — are considered not medically necessary and therefore excluded. The guideline lists related CPT codes for informational purposes only, specifies no covered indications or documentation requirements, and notes preauthorization requirements vary by payor.

"None specified in the guideline. (No explicit documentation requirements, required records, test results, or clinical documentation are listed in CMM-308."

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