22633 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

22633, Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient 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: 22633
Description: Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar
Source: New Hampshire Precertification List, Pg 93 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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