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Artificial Intervertebral Disc: Cervical Spine

Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, Neurosurgery·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply
—

Summary

This policy establishes medical necessity criteria for cervical disc arthroplasty (artificial cervical disc replacement) procedures. The policy defines when single-level, two-level contiguous, and subsequent cervical disc replacements are considered medically necessary versus investigational, requiring specific FDA-approved devices and clinical criteria including 6 weeks of failed conservative treatment.

Action Required

Action needed
Immediately: Billing team must review all cervical disc arthroplasty claims to ensure they meet the new medical necessity criteria before submission. Verify the specific FDA-approved device used (Prestige ST, ProDisc-C, Bryan, PCM, SECURE-C, Mobi-C, Prestige LP, M6-C, or Simplify) and confirm documentation of 6 weeks failed conservative treatment, skeletal maturity, and absence of contraindications. Claims not meeting these criteria will likely be denied.

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