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11.14.29h, Spinal Discectomy (Independence Administrators)
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
Independence Administrators has reissued policy 11.14.29h (now superseded by 11.14.29i as of 04/30/2025) for spinal discectomy with no substantive coverage changes. The policy continues to cover lumbar and cervical discectomy procedures meeting documented criteria (radiculopathy/myelopathy, failed conservative treatment, imaging confirmation). Annulus repair devices (Xclose, Barricaid, DART, Inclose) remain classified as experimental/investigational and are not covered. This is a routine annual policy reissuance with continued position communication.
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What to do
Action · 6 steps
01By 05/30/2025: Verify member eligibility and confirm plan enrollment status before processing spinal discectomy claims.
02NOTE: This policy applies ONLY to members where Independence Administrators is the claims administrator AND the group has NOT enrolled in the UM vendor program.
03For groups enrolled in UM vendor programs, this policy no longer applies as of their renewal effective date—verify individual member benefits in real-time.
04Billing team must ensure that annulus repair device procedure codes (C9757 including Xclose, Barricaid, DART, Inclose systems) are flagged for denial as experimental/investigational.
05Update any billing system rules or templates that reference version 11.14.29h to reference 11.14.29i.
06No workflow changes required if your practice already requires the documented criteria: radiculopathy/myelopathy signs, failed 6+ weeks conservative treatment, and corresponding imaging.
Codes mentioned
630206303063035S2350S2351C9757M50.00M50.01M50.020M50.021M50.022M50.023M50.03M50.10
Original notice
11.14.29h, Spinal Discectomy (Independence Administrators)
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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