CMM-605: Cervical Microdiscectomy

Cervical microdiscectomy (initial or repeat) is medically necessary for radiculopathy or myelopathy only when symptoms and objective neurologic findings are concordant with MRI/CT-demonstrated neural compression, radiculopathy patients have failed ≥2 conservative treatments (unless urgent/emergent), repeat surgery is >12 weeks from the prior procedure with post‑op imaging showing recurrent/retained compression, and urgent/emergent indications (e.g., progressive deficit, severe motor weakness, bowel/bladder dysfunction, cord signal change) may bypass some conservative‑care requirements but still require imaging and documentation. Not covered/excluded: procedures not meeting these criteria (including elective surgery for annular tears, degenerative disc disease alone, concordant discography or MR spectroscopy), percutaneous and endoscopic cervical discectomy (considered experimental/investigational), and elective cases with unmanaged significant mental/behavioral health disorders.