US · guidance
CMS Pub. 100-03, ch. 1, § 150.11
Thermal Intradiscal Procedures (TIPs) (Effective September 29, 2008)
A. General
Percutaneous thermal intradiscal procedures (TIPs) involve the insertion of a catheter(s)/probe(s) in the
spinal disc under fluoroscopic guidance for the purpose of producing or applying heat and/or disruption
within the disc to relieve low back pain.
The scope of this national coverage determination on TIPs includes percutaneous intradiscal techniques that
employ the use of a radiofrequency energy source or electrothermal energy to apply or create heat and/or
disruption within the disc for coagulation and/or decompression of disc material to treat symptomatic
patients with annular disruption of a contained herniated disc, to seal annular tears or fissures, or destroy
nociceptors for the purpose of relieving pain. This includes techniques that use single or multiple
probe(s)/catheter(s), which utilize a resistance coil or other delivery system technology, are flexible or rigid,
and are placed within the nucleus, the nuclear-annular junction, or the annulus.
Although not intended to be an all inclusive list, TIPs are commonly identified as intradiscal electrothermal
therapy (IDET), intradiscal thermal annuloplasty (IDTA), percutaneous intradiscal radiofrequency
thermocoagulation (PIRFT), radiofrequency annuloplasty (RA), intradiscal biacuplasty (IDB), percutaneous
(or plasma) disc decompression (PDD) or coblation, or targeted disc decompression (TDD). At times, TIPs
are identified or labeled based on the name of the catheter/probe that is used (e.g., SpineCath, discTRODE,
SpineWand, Accutherm, or TransDiscal electrodes). Each technique or device has it own protocol for
application of the therapy. Percutaneous disc decompression or nucleoplasty procedures that do not utilize a
radiofrequency energy source or electrothermal energy (such as the disc decompressor procedure or laser
procedure) are not within the scope of this NCD.
B. Nationally Covered Indications
N/A
C. Nationally Non-Covered Indications
Effective for services performed on or after September 29, 2008, the Centers for Medicare and Medicaid
Services has determined that TIPs are not reasonable and necessary for the treatment of low back pain.
Therefore, TIPs, which include procedures that employ the use of a radiofrequency energy source or
electrothermal energy to apply or create heat and/or disruption within the disc for the treatment of low back
pain, are noncovered.
D. Other
N/A
(This NCD last reviewed September 2008.)
History
(Rev. 97, Issued: 12-09-08, Effective: 09-29-08, Implementation: 01-05-09)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
f915f54d08e23f8709a5a5abedaca2020fe81c51f70a934562495056c5541b0c
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