22870 prior authorization | Anthem Blue Cross and Blue Shield Virginia

22870, Insertion of interlaminar/interspinous process stabilization/ distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 22870
Description: Insertion of interlaminar/interspinous process stabilization/ distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second
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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