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    v1.0.28
    OpenPayerPolicy UpdatesPain ManagementAmbetter Nevada Intradiscal Steroid Coverage | Ope…
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    CurrentAmbetter NevadaPolicy CP.MP.167

    Intradiscal Steroid Injections for Pain Management

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    This policy governs coverage and medical-necessity determinations for intradiscal glucocorticoid injections used to treat spinal discogenic pain for Ambetter Nevada members. The procedure is considered not medically necessary because effectiveness has not been established.

    Policy Summary
    PayerAmbetter Nevada
    PolicyIntradiscal Steroid Injections for Pain Management
    Policy CodePolicy CP.MP.167
    Change TypeAnnual reviewno material clinical or coverage change
    Effective DateOctober 1, 2026
    Last ReviewJul 1, 2026
    Next Review DateNot specified
    Key ActionClaims for intradiscal steroid injections may be denied because the procedure is considered not medically necessary.
    SourceLink
    POLICY UPDATE CHANGES

    Background and references were updated; clinical criteria and coverage were unchanged.

    Not medically necessaryCoverage stance
    22899Referenced CPT code
    6 monthsEvidence timepoint
    Limited/conflictingEvidence quality

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    Coverage Criteria

    Intradiscal Steroid Injections

    The procedure is considered not medically necessary.

    Not medically necessary: Intradiscal steroid injections are considered not medically necessary because effectiveness has not been established.

    Published literature reports both positive and negative results, and further research is ongoing to determine the safety and efficacy of injecting steroids directly into the disc.

    Intradiscal steroid injections are considered not medically necessary because their effectiveness has not been established. Published literature reports both positive and negative results, and further research is ongoing to determine the safety and efficacy of injecting steroids directly into the disc.

    Coding

    Referenced CPT CodeCPT
    22899Unlisted procedure, spine

    Provider Actions

    Denial Risk

    Claims may be denied as not medically necessary

    Intradiscal steroid injections are considered not medically necessary because effectiveness has not been established. Claims for the procedure may be denied on that basis.

    Background

    Intradiscal steroid injections deliver glucocorticoids directly into a spinal disc identified as the source of pain. For chronic discogenic low back pain, the evidence is limited and conflicting: some studies report short-term improvement, but benefits generally do not persist at six months, and functional or quality-of-life outcomes have not consistently improved. Potential concerns include discitis, progression of disc degeneration, and intervertebral-disc calcification.

    Definitions

    Definition
    ProcedureIntradiscal steroid injection
    Medication deliveredGlucocorticoids
    Injection siteSpinal disc
    Target discThe spinal disc identified as the source of pain

    Not Covered

    Intradiscal steroid injections for pain management are not covered because effectiveness has not been established.

    Policy Summary
    PayerAmbetter Nevada
    PolicyIntradiscal Steroid Injections for Pain Management
    Policy CodePolicy CP.MP.167
    Change TypeAnnual reviewno material clinical or coverage change
    Effective DateOctober 1, 2026
    Last ReviewJul 1, 2026
    Next Review DateNot specified
    Key ActionClaims for intradiscal steroid injections may be denied because the procedure is considered not medically necessary.
    SourceLink
    On This Page
    Coverage CriteriaCodingProvider ActionsBackgroundDefinitionsNot Covered