Intervertebral Disc Repair

This policy states that intervertebral disc injections (intradiscal/interdiscal) for the management of chronic low back pain are non-covered. No indications for coverage, documentation requirements, or frequency allowances are provided because the procedure is excluded from coverage.

"Intervertebral disc injections (intradiscal/interdiscal) for management of chronic low back pain are not covered."

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