22857 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
22857, Total disc arthroplasty (artificial disc), anterior approach, including 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
- 22857
- Description
- Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar
- Source
- New Hampshire Precertification List, Pg 95 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization