22612 prior authorization | Blue Cross and Blue Shield of Montana

22612, Arthrodesis Posterior Or Posterolateral Technique Single Interspace; Lumbar (With Lateral Transverse Technique When Performed), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 22612
Description: Arthrodesis Posterior Or Posterolateral Technique Single Interspace; Lumbar (With Lateral Transverse Technique When Performed)
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 19 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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