CMM-603 Posterior Cervical Decompression

Posterior cervical decompression (laminectomy/hemilaminectomy/laminoplasty) is covered for specific radiculopathy and myelopathy presentations, repeat procedures >12 weeks after prior surgery, and defined urgent/emergent conditions; procedures done solely for non‑correlative findings (e.g., annular tears, disc bulge without neural impingement, degenerative disc disease) and percutaneous or posterior endoscopic cervical decompressions are excluded/investigational. Coverage requires MRI/CT concordant with symptoms showing neural compression from specified pathologies (herniated disc, synovial/arachnoid cyst, central/lateral/foraminal stenosis, osteophytes), documented qualifying subjective and objective exam findings, failure of at least two 6‑week conservative therapies for radiculopathy (unless urgent), absence of unmanaged significant behavioral health/substance disorders, compliance with prior‑authorization/documentation rules, and >12 weeks since prior surgery for repeats.