UMR Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation prior authorization requirements (2026)
What UMR generally requires to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661), for commercial plans. Prior authorization requirements vary by plan. Confirm with UMR for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661).
Medical-necessity criteria UMR generally applies
Clinical criteria governed by UMR Medical Policy "Implanted Electrical Stimulator for the Spinal Cord." Spinal cord/dorsal-column stimulator review IS required for some employer groups (observed on a sampled group list); PA applicability is plan-specific — verify with the per-member PA tool on umr.com.
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 UMR policy.
How to submit
- Method: UMR provider portal (per-member PA tool)
- Portal: UMR
Sources & verification
- BindingSource — UMR Medical Policy — Implanted Electrical Stimulator for the Spinal Cord (UHC-published) · effective 2025-11-01.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 UMR require prior authorization for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?
Prior authorization requirements vary by plan. Confirm with UMR for Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation (CPT 63650, 63655, 63663, 63664, 63685, 63688, 63661).
What does UMR require to approve Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation?
Clinical criteria governed by UMR Medical Policy "Implanted Electrical Stimulator for the Spinal Cord." Spinal cord/dorsal-column stimulator review IS required for some employer groups (observed on a sampled group list); PA applicability is plan-specific — verify with the per-member PA tool on umr.com. Always confirm against the current UMR policy.
How long does a UMR prior authorization take?
Turnaround varies by plan and submission method. Check the UMR portal for current timeframes.
Submitting Dorsal Column (Lumbar) Neurostimulators: Trial or Implantation to UMR?
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.