22612 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

22612, Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 22612
Description: Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)
Source: New Hampshire Precertification List, Pg 92 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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