Braven Health Anterior Cervical Discectomy and Fusion prior authorization requirements (2026)
What Braven Health generally requires to approve Anterior Cervical Discectomy and Fusion (CPT 22551), for medicare_advantage plans. Yes. Braven Health generally requires prior authorization for Anterior Cervical Discectomy and Fusion (CPT 22551).
Medical-necessity criteria Braven Health generally applies
Prior authorization required — cervical spinal fusion (ACDF) and laminectomy/discectomy are listed under TurningPoint Spine Services, Braven in scope. Documented standard: conservative therapy first; PT notes, radiographs, documented surgical plan. Exact criteria in TurningPoint policy library.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Anterior Cervical Discectomy and Fusion. Confirm the covered diagnosis list against the current Braven Health policy.
How to submit
- Method: TurningPoint (Availity / portal / 1-833-436-4083)
- Portal: TurningPoint Healthcare Solutions
Sources & verification
- BindingSource — Surgical & Implantable Device Management Program — Spine Services.View
Binding = the payer's own policy. Proxy = a public, evidence-based clinical guideline the payer mirrors. Portal-only = the binding criteria are confirmed in the administrator's portal. Always confirm against the payer for the member's specific plan. Last verified 2026-06-26.
Frequently asked questions
Does Braven Health require prior authorization for Anterior Cervical Discectomy and Fusion?
Yes. Braven Health generally requires prior authorization for Anterior Cervical Discectomy and Fusion (CPT 22551).
What does Braven Health require to approve Anterior Cervical Discectomy and Fusion?
Prior authorization required — cervical spinal fusion (ACDF) and laminectomy/discectomy are listed under TurningPoint Spine Services, Braven in scope. Documented standard: conservative therapy first; PT notes, radiographs, documented surgical plan. Exact criteria in TurningPoint policy library. Always confirm against the current Braven Health policy.
How long does a Braven Health prior authorization take?
Turnaround varies by plan and submission method. Check the Braven Health portal for current timeframes.
Submitting Anterior Cervical Discectomy and Fusion to Braven Health?
Praxigen checks your clinical note against these criteria before you submit and drafts a policy-cited appeal if it is denied. You review and submit; nothing is sent automatically.