22857 prior authorization | Anthem Blue Cross and Blue Shield Virginia

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 Virginia HMO/EPO 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: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 14 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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