CurrentUnitedHealthcarePolicy SURGERY 056.31
Spinal Fusion and Bone Healing Enhancement Products
Defines UnitedHealthcare coverage rationale, definitions, applicable codes, evidence summary, and instructions for use related to spinal fusion bone grafts and biologic/augmentation products; lists products considered medically necessary versus unproven/not medically necessary and provides clinical evidence summaries. This is Part 1 of a multi-part policy.
Policy Summary
PayerUnitedHealthcare
PolicySpinal Fusion and Bone Healing Enhancement Products
Policy CodePolicy SURGERY 056.31
Change TypeDocumentation and reference updates
Effective DateOct 1, 2024
Next Review Date
Key ActionRefer to the protocol 'Medical Records Documentation Used for Reviews' and provide required documentation per that protocol when submitting cases for review.
POLICY UPDATE CHANGES
Medical Records Documentation Used for Reviews replaced the prior 'List of Required Clinical Information' in the documentation requirements section.
Clinical Evidence and References sections were updated to reflect current information and prior policy version SURGERY 056.30 was archived.
3Proven/Medically Necessary categories (examples)
4Unproven/Not Medically Necessary categories (examples)
5Representative CPT/Procedure codes listed
Multiple