QualCare Artificial Intervertebral Disc Surgery (Cervical Spine) prior authorization requirements (2026)

What QualCare generally requires to approve Artificial Intervertebral Disc Surgery (Cervical Spine) (CPT 22856, 22858, 22861), for commercial plans. Yes. QualCare 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 QualCare before submitting.

Medical-necessity criteria QualCare generally applies

Prior authorization via eviCore (Cigna CMM-602). Single-level or contiguous two-level C3-C7 via an anterior approach post-discectomy; skeletally mature; no prior surgery at the level; at least 6 weeks conservative care; MRI/CT neural compression.

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 QualCare policy.

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

How to submit

Sources & verification

  • BindingSource — Cigna CMM-602 Cervical Total Disc Arthroplasty (CMM-602) · effective 2025-07-01.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 QualCare require prior authorization for Artificial Intervertebral Disc Surgery (Cervical Spine)?

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

What does QualCare require to approve Artificial Intervertebral Disc Surgery (Cervical Spine)?

Prior authorization via eviCore (Cigna CMM-602). Single-level or contiguous two-level C3-C7 via an anterior approach post-discectomy; skeletally mature; no prior surgery at the level; at least 6 weeks conservative care; MRI/CT neural compression. Always confirm against the current QualCare policy.

How long does a QualCare prior authorization take?

Turnaround varies by plan and submission method. Check the QualCare portal for current timeframes.

Submitting Artificial Intervertebral Disc Surgery (Cervical Spine) to QualCare?

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 QualCare 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 ProceduresDorsal Column (Lumbar) Neurostimulators: Trial or ImplantationKnee ArthroscopyKnee MeniscectomyPain Management ProceduresShoulder Arthroscopy Rotator Cuff RepairSpinal Fusion SurgeryVertebroplasty/Kyphoplasty

Related guides

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