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Let’s talk: Complex spinal surgery and precertification requests


To help your patient get the most from their health benefits, it’s important to submit a precertification request for complex spinal procedures.

Here are some tips to help make your request go smoothly. We’ll need to see:
 

  • A completed a Spinal Surgery Precertification Information Request form
  • Details on any:
    • Implants/instrumentation/allografts (including CPT code(s), manufacturer, type of device and device name)
    • Spinal level(s) you’ll treat and your surgical approach
  • Medical records showing your patient’s signs and symptoms, including a detailed neuro exam
  • Physical therapy progress notes (at least six weeks within the last year or a discharge note from physical therapy)
  • All applicable radiological and imaging reports (e.g., CT, MRI) within the last year

When to submit your request

Be sure to submit precertification requests at least two weeks before the scheduled services.