63053 prior authorization | Anthem Blue Cross and Blue Shield Virginia

63053, Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis], is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 63053
Description: Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 25 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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