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).

General reference compiled from public sources, last verified 2026-06-26. This is not a coverage determination or medical advice. Always confirm current requirements with Braven Health before submitting.

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.

M96.1Postlaminectomy syndrome, not elsewhere classifiedG90.50Complex regional pain syndrome I, unspecifiedG89.4Chronic pain syndrome

How to submit

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.

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Other Braven Health prior authorization requirements

Anterior Cervical Discectomy and FusionArthroplasty (Joint Replacement)Arthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArtificial Intervertebral Disc Surgery (Cervical Spine)Artificial Intervertebral Disc Surgery (Lumbar Spine)Cervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresCT Cervical Spine without contrastCT Lumbar Spine without contrastKnee ArthroscopyKnee MeniscectomyMRI Cervical Spine with contrastMRI Cervical Spine without and with contrast

Related guides

Why was my prior authorization denied? Top reasons and how to fix eachHow to write a prior authorization appeal that cites policy