22632 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

22632, Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List separately in addition to code for primary procedure), is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 22632
Description: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List separately in addition to code for primary procedure)
Source: New Hampshire Precertification List, Pg 93 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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