20938 prior authorization | Blue Cross and Blue Shield of Montana

20938, Autograft For Spine Surgery Only (Includes Harvesting The Graft); Structural Bicortical Or Tricortical (Through Separate Skin Or Fascial Incision) (List Separately In Addition To Code For Primary Procedure), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 20938
Description: Autograft For Spine Surgery Only (Includes Harvesting The Graft); Structural Bicortical Or Tricortical (Through Separate Skin Or Fascial Incision) (List Separately In Addition To Code For Primary Procedure)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 8 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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