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22858 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

22858, Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (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
22858
Description
Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure)
Source
New Hampshire Precertification List, Pg 95 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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