Lumbar Fusion - (Effective Date - 2026-10-15) 7.01.117
Excellus BlueCross BlueShield's Lumbar Fusion policy (07.01.117) is effective October 15, 2026. The June 18, 2026 annual review updated the criteria for documentation of nicotine-free status, and the January 22, 2026 off-cycle review changed the pelvic incidence-lumbar lordosis criterion to greater than 15 degrees. The policy covers lumbar fusion with and without decompression, repeat fusion at the same level, adjacent segment disease, fusion after failed disc arthroplasty, pediatric spinal deformity, and spinal osteotomy.