Coverage Decisions for Medical Technologies & Procedures

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Coverage Decisions for Medical Technologies & Procedures

Percutaneous Discectomy for Disc Herniation

Coverage decision

L&I does not cover percutaneous discectomy procedures, including:

Automated percutaneous lumbar discectomy.
Percutaneous laser discectomy.
Nucleoplasty.

Automated percutaneous lumbar discectomy is considered controversial because evidence does not show its efficacy over conventional discectomy. Due to the lack of quality studies with comparison groups, laser percutaneous discectomy and nucleoplasty are considered investigational.

Manual percutaneous discectomy and automated percutaneous lumbar discectomy are considered controversial because evidence does not show their efficacy over conventional discectomy. Due to the lack of quality studies with comparison groups, laser percutaneous discectomy and nucleoplasty are considered investigational.

Percutaneous discectomy is a class of minimally invasive surgical procedures that treat contained, herniated discs. Specific procedures within the class include manual percutaneous lumbar discectomy, automated percutaneous lumbar discectomy (APLD), laser discectomy, and nucleoplasty.

Manual discectomy removes disc material with forceps whereas APLD removes disc material with a suction cutting probe. Laser discectomy uses laser energy transformed into heat to vaporize disc tissue. Finally, Nucleoplasty uses radiofrequency energy to break molecular bonds within tissue, creating small channels in the disc.

PDF icon Provider Bulletin 04-06 (76 KB PDF).
Percutaneous Discectomy technology assessment (668 KB PDF / 4 min)

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