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HCPCS/CPT C2614, Probe, percutaneous lumbar discectomy | Prior Auth Required

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`C2614`, Probe, percutaneous lumbar discectomy

HCPCS/CPT

Prior Authorization

Prior Auth Required

Code explicitly requires prior authorization (high confidence)

Key Coverage Criteria

Automated percutaneous and percutaneous endoscopic discectomy are considered investigational as techniques for intervertebral disc decompression in patients with back pain and/or radiculopathy related to disc herniation in the lumbar, thoracic, or cervical spine.

4 Active Policies

ANTHEM-SURG.00071, Percutaneous and Endoscopic Spinal Surgery

EVICORE-HPLAN-CIGNA-AFCE721BA4F3, Cigna Comprehensive Code List - Effective 03/07/2026

EVICORE-HPLAN-CIGNA-5EF639BE0AD8, Cigna Commercial Spine Surgery Code List - Effective 03/07/2026

REGENCE-SUR145, Automated Percutaneous and Percutaneous Endoscopic Discectomy

Related Codes

62380(4 policies)62287(4 policies)64999(4 policies)22899(3 policies)20938(2 policies)20939(2 policies)20975(2 policies)20936(2 policies)

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