Neurology & Pain Management Coding Alert

Question: Does Medicare still cover intradiscal electrothermal therapy (IDET)?

South Dakota Subscriber

Answer: CMS has ruled that thermal intradiscal procedures (TIPs), including IDET, are officially non-covered services.

A CMS ruling states, "Effective for services performed on or after September 29, 2008, the Centers for Medicare & Medicaid Services (CMS) has concluded that the evidence does not demonstrate that TIPs improve health outcomes; and has therefore determined that TIPs are not reasonable and necessary for the treatment of low back pain."

TIPs are more than IDET: The term "TIPs" refers to percutaneous intradiscal techniques using devices that employ radiofrequency energy or electrothermal energy to create heat and/or disruption in the disc, according to the national coverage determination (NCD). This description includes the following procedures, among others:

- intradiscal electrothermal therapy (IDET)

- intradiscal thermal annuloplasty (IDTA)

- percutaneous intradiscal radiofrequency thermocoagulation (PIRFT)

- radiofrequency annuloplasty (RA)

- intradiscal biacuplasty (IDB)

- percutaneous (or plasma) disc decompression (PDD) or ablation

- targeted disc decompression (TDD).

Find the NCD at www.cms.hhs.gov/transmittals/downloads/R1646CP.pdf