NY State Workers' Comp Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation prior authorization requirements (2026)

What NY State Workers' Comp generally requires to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661), for workers_comp plans. Yes. NY State Workers' Comp 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 2026-06-25. This is not a coverage determination or medical advice. Always confirm current requirements with NY State Workers' Comp before submitting.

Medical-necessity criteria NY State Workers' Comp generally applies

Spinal cord stimulator ALWAYS requires prior authorization (324.3 pre-auth list): conditional pre-authorization for a screening trial, then a separate authorization for permanent implant; requires a comprehensive psychological evaluation with no primary psychiatric red flags. Request via OnBoard.

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 NY State Workers' Comp policy.

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

How to submit

Sources & verification

  • BindingSource — NY WCB Non-Acute Pain Medical Treatment Guidelines · effective 2022-05-02.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 2026-06-25.

Frequently asked questions

Does NY State Workers' Comp require prior authorization for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?

Yes. NY State Workers' Comp generally requires prior authorization for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661).

What does NY State Workers' Comp require to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?

Spinal cord stimulator ALWAYS requires prior authorization (324.3 pre-auth list): conditional pre-authorization for a screening trial, then a separate authorization for permanent implant; requires a comprehensive psychological evaluation with no primary psychiatric red flags. Request via OnBoard. Always confirm against the current NY State Workers' Comp policy.

How long does a NY State Workers' Comp prior authorization take?

Turnaround varies by plan and submission method. Check the NY State Workers' Comp portal for current timeframes.

Submitting Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation to NY State Workers' Comp?

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 NY State Workers' Comp prior authorization requirements

Anterior Cervical Discectomy and FusionArthroplasty (Joint Replacement)Knee ArthroscopyPain Management ProceduresShoulder Arthroscopy Rotator Cuff RepairSpinal Fusion Surgery

Related guides

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