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Advisory 2001-04

Prospective Review of Intra Discal Electro Thermal Treatment (IDET)

The Commission provides the following clarification regarding Intra Discal Electro Thermal treatment (IDET) for injured employees covered under the Texas Workers' Compensation Act.

The Commission did not include IDET as a normative course of treatment in the Spine Treatment Guideline because it was determined that there were no existing scientific studies to support the use of IDET as a normal course of treatment. However, that determination does not preclude the procedure from being reimbursed in accordance with TWCC policy as clarified in this Advisory.

IDET is not spinal surgery for purposes of TWCC Rule 133.206 (Spinal Surgery Second Opinion process). Therefore compliance with TWCC Rule 133.206 is not required. However, if the IDET procedure is performed in a hospital or as ambulatory surgical center care, preauthorization is required pursuant to TWCC Rule 134.600(h)(1).

Although this Advisory clarifies that for the purposes of TWCC Rule 133.206, IDET is not spinal surgery, the carrier is liable for any IDET procedures for which a prospective determination of medical necessity has already been made, or is in the process of being made, through the procedures set forth in TWCC Rule 133.206. Effective April 12, 2001 IDET procedures will not be accepted by the Commission under the Spinal Surgery Second Opinion process. IDET procedures performed in a hospital or as ambulatory surgical center care must be preauthorized in accordance with TWCC Rule 134.600 for an insurance carrier to be held liable for the reasonable and necessary medical costs relating to the IDET procedure.

As is the case with any approval of a request for preauthorization, the approval of an IDET procedure does not guarantee payment if the injury is finally adjudicated as non-compensable or the health care was provided for a condition that is finally adjudicated as being unrelated to the compensable injury.

Signed this 11 th of April, 2001

Leonard W. Riley, Jr., Executive Director

cc: TWCC Staff, Commission Representatives, Public Information List, Professional Medical Associations