CMM-601: Anterior Cervical Discectomy and Fusion

Covered: anterior cervical discectomy/corpectomy with fusion (including osteotomy/VCR when fusion alone cannot correct fixed kyphosis) is medically necessary for urgent/emergent neurocompressive conditions, myelopathy or radiculopathy with concordant exam/imaging after failed nonoperative care, corpectomy for infection/trauma/tumor/compression, and select repeat/adjacent‑segment or arthroplasty‑conversion procedures; ACDF/corpectomy without fusion, chronic non‑specific neck pain or degenerative disc disease without radiculopathy/myelopathy, and certain anterior endoscopic techniques are excluded/experimental. Key requirements: concordant plain X‑rays (including flexion/extension) and MRI/CT, documentation of failed conservative therapy (typically ≥2 treatments/6 weeks unless urgent), nicotine‑free status (cotinine ≤10 ng/mL or never‑smoker), absence of unmanaged behavioral health disorders, and timing/post‑op imaging rules for revisions (eg, >6 months and imaging to demonstrate pseudoarthrosis), with some preauthorization criteria waived for urgent/emergent cases.