Prior Auth Required

22527 - • Percutaneous intradiscal electrothermal annuloplasty [IDET] ( )

This procedure appears on the selected insurer prior authorization source.

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Procedure / Service• Percutaneous intradiscal electrothermal annuloplasty [IDET] ( )
Procedure / Service Description

POLICY NAME: PAIN MANAGEMENT SERVICES - • Non-thermal modalities for facet joint denervation including chemical, low-grade thermal energy (less than 80 degrees Celsius), laser neurolysis, and cryoablation • Percutaneous intradiscal electrothermal annuloplasty [IDET] (22527) • Percutaneous lysis of epidural adhesions, Racz procedure (62263, 62264) • Peripheral nerve blocks for conditions other than those stated within this policy, to include

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  • Submit clinical notes if requested by the plan
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  • Use the insurer authorization workflow for this listed code.