Artificial Intervertebral Disc Replacement - Medicare Advantage

This policy covers FDA‑approved artificial intervertebral disc replacement (cervical single- or two‑level and lumbar single‑level total disc replacement at L3–S1) as an alternative to fusion for symptomatic degenerative disc disease (DDD) causing neck or back pain. Coverage is limited to skeletally mature patients who have failed ≥6 months of conservative therapy (including PT/HEP, NSAIDs, activity modification and epidural steroid injection if appropriate), have no contraindications (e.g., ≤Grade I spondylolisthesis), receive an FDA‑approved device, and is subject to applicable Medicare NCDs/LCDs and MAC jurisdictional requirements (in jurisdictions without an LCD, lumbar replacement is considered reasonable for patients ≤60 when all criteria are met).

"No explicit documentation requirements are present in the provided document excerpt."

Sign up to see full coverage criteria, indications, and limitations.