22870 prior authorization | Anthem Blue Cross Blue Shield of California
22870, Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (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
- 22870
- Description
- Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure)
- Source
- California PPO Prior Authorization List, Pg 37 Original policy
Anthem Blue Cross Blue Shield of California prior authorization