CMM-602: Cervical Total Disc Arthroplasty

Cervical total disc arthroplasty (TDA) is medically necessary for urgent/emergent neurocompressive conditions and for selected primary or adjacent‑segment radiculopathy or myelopathy at C3–C7 limited to a single level or two contiguous levels, and is not medically necessary for DDD as the sole indication, revisions at the same level, procedures >2 or noncontiguous levels, prior surgery at the operative level, or when listed experimental/investigational criteria apply (e.g., age <18 or >60, significant instability, active infection, severe metabolic/bone disease, OPLL, or severe facet arthropathy). Key requirements include skeletal maturity, use of an FDA‑approved device per labeling, recent (≤6 months) MRI/CT and flexion/extension X‑rays showing concordant pathology without significant instability, documentation of specified objective exam findings and symptom severity, failure of ≥2 conservative treatments (unless urgent/emergent), and absence of unmanaged significant mental/behavioral health disorders.