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AetnaAll Plans · Coverage · Medical Policy · Pain Management, Neurosurgery, RadiologyMedium impact

Discography (CPB 0733, reviewed 2025-06-17)

Effective date
Not stated in the notice
Identified
Aug 14, 2026

Summary

Aetna considers lumbar provocative discography medically necessary to evaluate disc pathology in members with persistent, severe low back pain and abnormal interspaces on MRI, when other diagnostic tests have not clearly confirmed a suspected disc as the source of pain and surgical intervention is being considered. Discography is not recommended as a stand-alone test for treatment decisions and should not be attempted in people with a normal lumbar MRI. Lumbar provocative discography for all other indications, cervical and thoracic provocative discography, functional anesthetic discography, and contrast disc analysis and mapping are considered experimental, investigational, or unproven.

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What to do

Action · 5 steps
01Billing team: Before billing lumbar discography (CPT 62290 and 72295), confirm the case meets the policy criteria: persistent, severe low back pain, abnormal interspaces on MRI, other diagnostic tests that have not clearly confirmed the suspected disc as the pain source, and surgical intervention being considered.
02Do not bill lumbar discography for patients with a normal lumbar MRI.
03Lumbar discography for lumbosacral radiculopathy and chronic non-specific back pain is experimental, investigational or unproven when those criteria are not met.
04Do not bill cervical or thoracic discography (CPT 62291 and 72285), functional anesthetic discography, or contrast disc analysis and mapping, which the policy considers experimental, investigational or unproven.
05CPT 62290 and 72295 are not covered for functional anesthetic discography.

Codes mentioned

62290722956229172285Q9951M47.16M51.06M96.1

Original notice

Discography (CPB 0733, reviewed 2025-06-17)
aetna.com · Always check the source before changing claims.
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Related policy hubs

Aetna policiesPain ManagementNeurosurgeryRadiologyCode 62290Code 72295Code 62291Code 72285Code Q9951Code M47.16Code M51.06Code M96.1

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