Oxford Health Plans Artificial Intervertebral Disc Surgery (Cervical Spine) prior authorization requirements (2026)

What Oxford Health Plans generally requires to approve Artificial Intervertebral Disc Surgery (Cervical Spine) (CPT 22856, 22858, 22861), for commercial plans. Yes. Oxford Health Plans generally requires prior authorization for Artificial Intervertebral Disc Surgery (Cervical Spine) (CPT 22856, 22858, 22861).

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 Oxford Health Plans before submitting.

Medical-necessity criteria Oxford Health Plans generally applies

Prior authorization required; proven/medically necessary for one or two CONTIGUOUS levels of cervical DDD (C3-C7), skeletally mature with radiculopathy and/or myelopathy, an FDA-approved disc (a 2-level device for two levels). Also proven after a prior fusion that shows radiographically complete arthrodesis. Hybrid cervical surgery (disc plus fusion) is unproven.

Diagnoses that commonly support medical necessity

ICD-10-CM diagnoses frequently associated with medical necessity for Artificial Intervertebral Disc Surgery (Cervical Spine). Confirm the covered diagnosis list against the current Oxford Health Plans policy.

M50.120Cervical disc disorder with radiculopathy, unspecified cervical regionM50.020Cervical disc disorder with myelopathy, unspecified cervical region

How to submit

Sources & verification

  • BindingSource — UHC Commercial/Exchange Medical Policy — Total Artificial Disc Replacement for the Spine (2026T0437PP) · effective 2026-02-01.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 2026-06-26.

Frequently asked questions

Does Oxford Health Plans require prior authorization for Artificial Intervertebral Disc Surgery (Cervical Spine)?

Yes. Oxford Health Plans generally requires prior authorization for Artificial Intervertebral Disc Surgery (Cervical Spine) (CPT 22856, 22858, 22861).

What does Oxford Health Plans require to approve Artificial Intervertebral Disc Surgery (Cervical Spine)?

Prior authorization required; proven/medically necessary for one or two CONTIGUOUS levels of cervical DDD (C3-C7), skeletally mature with radiculopathy and/or myelopathy, an FDA-approved disc (a 2-level device for two levels). Also proven after a prior fusion that shows radiographically complete arthrodesis. Hybrid cervical surgery (disc plus fusion) is unproven. 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 Artificial Intervertebral Disc Surgery (Cervical Spine) 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

Anterior Cervical Discectomy and FusionArthroplasty (Joint Replacement)Arthroscopic Hip Surgery for Impingement Syndrome Including Labral RepairArtificial Intervertebral Disc Surgery (Lumbar Spine)Cervical, Lumbar and Thoracic Laminectomy and/or Laminotomy ProceduresCT Cervical Spine without contrastCT Lumbar Spine without contrastDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee 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