Billing and Coding: Cervical Fusion

This billing and coding article applies to cervical fusion and related cervical-spine fusion procedures and defers to LCD L39793 for clinical reasonable and necessary criteria. It requires complete, legible medical record documentation (including signatures, supporting ICD-10/CPT coding, operative reports, and documentation of medical necessity), mandates reporting referring physician NPI when required, and prohibits use of non–FDA-approved biological injectants (e.g., amniotic/placenta-derived products, PRP) which will cause claim denial.

"Cervical fusion and related cervical-spine fusion procedures are within the scope of this billing/coding guidance and are covered when they meet the reasonable and necessary requirements in LCD L39..."

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