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Essential Documentation for the Intracept CPT Code Successful authorization of the intracept cpt code requires comprehensive medical records: Patient History: Detailed record of chronic low back pain (duration, location, severity) Physical Exam Findings: Notes supporting vertebrogenic pain diagnosis Failed Conservative Therapies: Critical documentation showing at least six months of unsuccessful treatments: Physical therapy records Medication history Other treatments (chiropractic, acupuncture) Prior injections without lasting relief MRI Report: Radiologist report explicitly identifying Type 1 or Type 2 Modic changes Letter of Medical Necessity: Physician summary explaining why Intracept is necessary Steps for a Successful Prior Authorization Submit Request: Initiate with relevant CPT and ICD-10 codes Provide Documentation: Submit complete medical records through insurers portal Payer Review: Clinical reviewer assesses against coverage policy Decision: Approval allows scheduling

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2015;1:CD009403

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