22630 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
22630, Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 22630
- Description
- Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar
- Source
- New Hampshire Precertification List, Pg 92 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization