22867 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

22867, Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 22867
Description: Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
Source: New Hampshire Precertification List, Pg 96 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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