Oxford Health Plans Anterior Cervical Discectomy and Fusion prior authorization requirements (2026)

What Oxford Health Plans generally requires to approve Anterior Cervical Discectomy and Fusion (CPT 22551), for commercial plans. Yes. Oxford Health Plans generally requires prior authorization for Anterior Cervical Discectomy and Fusion (CPT 22551).

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 Oxford Health Plans before submitting.

Medical-necessity criteria Oxford Health Plans generally applies

Prior authorization required for cervical fusion/ACDF (22551). UnitedHealthcare Provider Portal.

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 Oxford Health Plans policy.

M54.12Radiculopathy, cervical regionM47.12Other spondylosis with myelopathy, cervical regionM48.02Spinal stenosis, cervical region

How to submit

Sources & verification

  • BindingSource — Prior Authorization Requirements for Oxford (PCA-1-22-03771) · effective 2026-01-01.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 Oxford Health Plans require prior authorization for Anterior Cervical Discectomy and Fusion?

Yes. Oxford Health Plans generally requires prior authorization for Anterior Cervical Discectomy and Fusion (CPT 22551).

What does Oxford Health Plans require to approve Anterior Cervical Discectomy and Fusion?

Prior authorization required for cervical fusion/ACDF (22551). UnitedHealthcare Provider Portal. Always confirm against the current Oxford Health Plans policy.

How long does a Oxford Health Plans prior authorization take?

Turnaround varies by plan and submission method. Check the Oxford Health Plans portal for current timeframes.

Submitting Anterior Cervical Discectomy and Fusion to Oxford Health Plans?

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 Oxford Health Plans prior authorization requirements

Arthroplasty (Joint Replacement)Dorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee 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