Summary
UMR's November 2026 medical policy bulletin removes CPT codes 22850, 22855, and 63286 from the Spinal Fusion and Decompression policy, effective 2026-12-01. Billing teams should stop relying on these codes for UMR claims for dates of service on or after that date and confirm charge entry no longer routes these codes to this policy.
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What to do
Action · 3 steps
01By 2026-12-01: Billing team should update charge entry and claim edits so CPT 22850, 22855, and 63286 are no longer used as covered spinal fusion or decompression codes for UMR members, and confirm with providers and front desk staff that these codes are not scheduled or documented for UMR patients under this policy.
02Before scheduling any affected spinal procedure for UMR members on or after 2026-12-01, check the current UMR policy and the bulletin before choosing codes, and update the prior auth tracker so requests for these codes are not submitted under the Spinal Fusion and Decompression policy.
03Watch for the payer's next notice on any replacement codes or requirements.
Codes mentioned
228502285563286
Original notice
Spinal Fusion and Decompression
uhcprovider.com · Always check the source before changing claims.
Related changes
See all UnitedHealthcare changes →Spinal Fusion and DecompressionMediumEffective Dec 1, 2026 · Medical PolicySpinal Fusion and DecompressionMediumEffective Dec 1, 2026 · Medical PolicySpinal Fusion and DecompressionMediumEffective Dec 1, 2026 · Medical PolicySpinal Fusion and DecompressionHighEffective Nov 1, 2026 · Medical PolicyBrowse every UnitedHealthcare change in the policy list