22842 prior authorization | Anthem Blue Cross Blue Shield of California

22842, Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 22842
Description: Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)
Source: California PPO Prior Authorization List, Pg 84 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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