CurrentArizona Complete HealthPolicy CP.MP.114

Disc Decompression Procedures

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Defines medical necessity and coding guidance for open discectomy and microdiscectomy versus minimally invasive disc decompression procedures for members/enrollees with lumbar disc herniation. Applies to health plans affiliated with Centene Corporation as adopted by Arizona Complete Health.

Policy Summary

PayerArizona Complete Health

PolicyDisc Decompression Procedures

Policy CodePolicy CP.MP.114

Change TypeAnnual review — no material change

Effective Date

Next Review Date

Key ActionObtain prior authorization with supporting documentation (age, imaging, deficits, and records of conservative therapy) for listed procedure codes.

SourceLink

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