Prior Auth Required

28296 - 150.13 Percutaneous Image-Guided

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service150.13 Percutaneous Image-Guided
Procedure / Service Description

Intradiscal Procedures (TIPs) NCD - (LADR) NCD 150.11 Thermal 34841-34843, 34845-34848 Intradiscal Procedures (TIPs) NCD 150.13 Percutaneous Image-Guided 26535, 26536, 28110, 28240, 28285, 28289, 28291, 28292, 28295-28299, 28306, Lumbar Decompression for Lumbar 28308, 28310, 28740, 28750, L8641 Spinal Stenosis LCD L36406

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.