CPT 0628T · Intradiscal · Medicare (Noridian JF MAC)
ViaDisc — Lumbar (additional level) at Medicare (Noridian JF MAC).
How Medicare (Noridian JF MAC) approaches CPT 0628T (ViaDisc — Lumbar (additional level)) for prior-authorization review: at last review on 2026-04-26, the policy does not cover this code without prior authorization.
Free with practitioner sign-in — magic-link email auth, no credit card.
Clearway-MPG-ViaDiscCriteria summary
High-level themes from the Medicare (Noridian JF MAC) policy of record for CPT 0628T. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Clearway Master Payer Guidelines v2025 — ViaDisc
See the full Medicare (Noridian JF MAC) criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →