LCDActive
Intervertebral Disc Repair
L39960
Effective: September 11, 2025
Updated: December 31, 2025
Policy Summary
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.
Coverage Criteria Preview
Key requirements from the full policy
"Intervertebral disc injections (intradiscal/interdiscal) for management of chronic low back pain are not covered."
Sign up to see full coverage criteria, indications, and limitations.
Covered Medical Codes