22633 prior authorization | Anthem Blue Cross Blue Shield of California
22633, Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.
- Code
- 22633
- Description
- Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; lumbar
- Source
- California PPO Prior Authorization List, Pg 84 Original policy
Anthem Blue Cross Blue Shield of California prior authorization