Does S2348 require prior authorization?

Yes, S2348 requires prior authorization (high confidence). At least one active policy explicitly requires prior authorization.

What is the Medicare reimbursement rate for S2348?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

Backwork Sign up free

`S2348`, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral

HCPCS/CPT

Prior Authorization

Prior Auth Required

At least one active policy explicitly requires prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Member-specific benefit plan document must be referenced when deciding coverage; 'When deciding coverage, the member specific benefit plan document must be referenced as the terms of the member specific benefit plan may differ from the standard plan.' (Instructions for Use)

Informational (FDA PMA language): For Barricaid® (PMA), indication requires confirmation 'by history, physical examination and imaging studies which demonstrate neural compression using MRI' and that the device is used 'to treat a large annular defect (between 4-6 mm tall and between 6-10 mm wide) following a primary discectomy procedure at a single level between L4 and S1.' (U.S. Food and Drug Administration section)

Applicable codes and coding lists are provided for reference only and do not establish coverage; documentation should support medical necessity per the member's benefit plan and any applicable federal/state mandates. (Applicable Codes / Instructions for Use)

If consideration for a related procedure (e.g., percutaneous discectomy) is made, follow documentation requirements in the referenced Medical Policy 'Minimally Invasive Spine Surgery Procedures.' (Coverage Rationale / Note)

Key Coverage Criteria

None — this Medical Policy states the following procedures are unproven and not medically necessary due to insufficient evidence of efficacy: Annular closure devices (ACDs); Percutaneous injection of allogeneic cellular/tissue-based products; Thermal intradiscal procedures (TIPs) for treating discogenic pain. (Coverage Rationale)
Note (informational, not a payer coverage determination): FDA premarket approval (PMA) for the Barricaid® Annular Closure Device is described in the document: 'indicated for reducing the incidence of reherniation and reoperation in skeletally mature patients with radiculopathy (with or without back pain) attributed to a posterior or posterolateral herniation, and confirmed by history, physical examination and imaging studies which demonstrate neural compression using MRI to treat a large annular [...]
Intraoperative EMG monitoring of the facial nerve during surgery for cholesteatoma, including mastoidotomy or mastoidectomy
ICD-10 codes covered if selection criteria are met for intraoperative SEPs (as listed): "H93.3x1 - H93.3x9" Disorders of acoustic nerve [compression].
ICD-10 codes covered if selection criteria are met for intraoperative SEPs (as listed): "I06.0 - I06.9" Diseases of aortic valve.
ICD-10 codes covered if selection criteria are met for intraoperative SEPs (as listed): "I35.0 - I35.9" Nonrheumatic aortic valve disorders.

14 Active Policies

ANTHEM-SURG.00071, Percutaneous and Endoscopic Spinal Surgery

EVICORE-HPLAN-HAP-AB9D421BCDBD, Health Alliance Plan MSK Code List - Effective 01/01/2026

EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-8C1D8DD0096D, Health Partners Plans Spine Surgery Code List - Effective 01/01/2025

UHC-POL-discogenic-pain-treatment, Discogenic Pain Treatment

AETNA-CPB-0697, Intraoperative Neurophysiological Monitoring

AETNA-CPB-0602, Intradiscal Procedures

AMBETTER-CP.MP.114, Disc Decompression Procedures

BCBSIL-SUR712.037, Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)

BCBSMT-SUR712.037, Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)

BCBSNM-SUR712.037, Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)

BCBSOK-SUR712.037, Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)

REGENCE-SUR131, Decompression of Intervertebral Discs Using Laser Energy (Laser Discectomy) or Radiofrequency Energy (Nucleoplasty)

UMR-POL-UMR-discogenic-pain-treatment, Discogenic Pain Treatment

SUREST-POL-SUREST-discogenic-pain-treatment, Discogenic Pain Treatment

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about S2348 Sign up free

S2348, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral