CMM-614: Thoracic and Thoracolumbar Fusion (Athrodesis)

Covers thoracic and thoracolumbar fusion and specified osteotomies when criteria are met (e.g., urgent/emergent instability from fracture/infection/neoplasm, pediatric scoliosis >50°, adult deformity meeting coronal/sagittal thresholds, iatrogenic/adjacent-segment instability, symptomatic pseudoarthrosis) and excludes fusion for multilevel degenerative disc disease or facet disorders without instability and other procedures/devices deemed experimental. Key requirements include confirmatory imaging (including dynamic studies), documented failure of specified nonoperative care (typically ≥3 months or 6 weeks for pseudoarthrosis), nicotine abstinence proven by blood cotinine ≤10 ng/mL or never-smoker status, absence of unmanaged significant behavioral health disorders for some indications, and limits such as a maximum of four posterior column osteotomies per correction (urgent/emergent cases exempt from some preconditions).

"Urgent/emergent conditions for thoracic or thoracolumbar fusion and/or osteotomy include ANY of the following: Traumatic spinal fractures or dislocations with or without neural compression when ins..."