Spine Surgery - MEDICAID - SOUTH CAROLINA

This policy addresses coverage for spine surgeries including open and minimally invasive spinal fusion (cervical, thoracic, lumbar), sacroiliac joint (SIJ) fusion (e.g., iFUSE and other triangular, threaded, or barrel implants), and use of bone grafts/substitutes for patients with SIJ dysfunction, degenerative disc disease, scoliosis/kyphosis, spondylolisthesis, trauma, infection, or tumor-related instability. Coverage is subject to plan- and device-specific requirements (including FDA approval), may include age limits (example: ≤60 years noted), and newer procedures such as vertebral body tethering or certain artificial disc replacements are described as proposed/investigational with no explicit coverage in this excerpt.

"CPT 64866: Anastomosis; facial-spinal accessory"

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