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HCPCS/CPT C9355, Collagen nerve cuff (neuromatrix), per 0.5 centimeter length | No Prior Auth

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`C9355`, Collagen nerve cuff (neuromatrix), per 0.5 centimeter length

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

No specific documentation requirements, prior authorization criteria, or required clinical documentation are stated in this CPB. (Policy contains literature review, statements of experimental/investigational status, and lists of CPT/HCPCS/ICD-10 codes not covered, but does not specify required documentation fields.)

Key Coverage Criteria

Prompt repair of acute phrenic nerve transection due to trauma or surgery. (Note in policy: "Phrenic nerve reconstruction for the treatment of diaphragmatic paralysis (Note: this does not apply to prompt repair of acute phrenic nerve transection due to trauma or surgery)")
No other specific indications are affirmatively listed as covered in this CPB; multiple nerve grafting and nerve reconstruction interventions are described in the literature review but are explicitly identified in this policy as experimental and investigational (see Limitations).

1 Active Policy

AETNA-CPB-0416, Nerve Grafting and Reconstruction: Selected Indications

Related Codes

55840(1 policies)55842(1 policies)55845(1 policies)55866(1 policies)64911(1 policies)64912(1 policies)64913(1 policies)C9352(1 policies)

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