Braven Health Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation prior authorization requirements (2026)
What Braven Health generally requires to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661), for medicare_advantage plans. Yes. Braven Health generally requires prior authorization for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661).
Medical-necessity criteria Braven Health generally applies
Prior authorization required. NOTE a real vendor-routing ambiguity: TurningPoint Spine Services lists "Spinal Cord Neurostimulator" and implantable pain pumps, AND eviCore's MSK Pain Management program also lists spinal cord stimulators — confirm which vendor handles the specific code before submission. As a Medicare Advantage plan, CMS NCD 160.7 (late-resort, multidisciplinary screening, successful trial before permanent implant) is the floor; eviCore CMM-211 applies where eviCore governs. Mental-health evaluation and a successful trial are standard but the exact eviCore threshold text was not retrieved.
Diagnoses that commonly support medical necessity
ICD-10-CM diagnoses frequently associated with medical necessity for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation. Confirm the covered diagnosis list against the current Braven Health policy.
How to submit
- Method: TurningPoint or eviCore (verify routing by code)
- Portal: TurningPoint Healthcare Solutions
Sources & verification
- BindingSource — Surgical & Implantable Device Management Program — Spine Services (Spinal Cord Neurostimulator).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 Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?
Yes. Braven Health generally requires prior authorization for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661).
What does Braven Health require to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?
Prior authorization required. NOTE a real vendor-routing ambiguity: TurningPoint Spine Services lists "Spinal Cord Neurostimulator" and implantable pain pumps, AND eviCore's MSK Pain Management program also lists spinal cord stimulators — confirm which vendor handles the specific code before submission. As a Medicare Advantage plan, CMS NCD 160.7 (late-resort, multidisciplinary screening, successf… 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 Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation 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.