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Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, Biacuplasty and Intraosseous Basivertebral Nerve Ablation
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Percutaneous intradiscal electrothermal annuloplasty, intradiscal radiofrequency annuloplasty, and intradiscal biacuplasty for chronic discogenic back pain are considered investigational under this BCBS policy. Intraosseous radiofrequency ablation of the basivertebral nerve, such as the Intracept system, for vertebrogenic back pain is also considered investigational. Unlisted spine procedure code 22899 is listed for the Intercept procedure. The policy was last reviewed 09/16/2026 with no changes.
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What to do
Action · 4 steps
01Billing team: Before billing percutaneous intradiscal annuloplasty (CPT 22526 or 22527) or basivertebral nerve ablation (CPT 64628 or 64629), check the member's specific benefit plan language, because the Medical Policy Manual guidelines should not be used in place of it.
02Under this policy these services are investigational, which the policy defines as not yet a generally accepted standard of good medical practice and therefore not considered medically necessary.
03Unlisted spine code 22899 is the code the source lists for the Intercept procedure.
04For Federal Employee Program members, FDA-approved devices may be assessed only on the basis of medical necessity.
Codes mentioned
225262252722899646286462964999
Original notice
Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, Biacuplasty and Intraosseous Basivertebral Nerve Ablation
bcbsms.com · Always check the source before changing claims.
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