63052 prior authorization | Blue Cross and Blue Shield of Montana
63052, Laminectomy Facetectomy Or Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And/Or Nerve Root[S] [Eg Spinal Or Lateral Recess Stenosis]) During Posterior Interbody Arthrodesis Lumbar; Single Vertebral Segment (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
- 63052
- Description
- Laminectomy Facetectomy Or Foraminotomy (Unilateral Or Bilateral With Decompression Of Spinal Cord Cauda Equina And/Or Nerve Root[S] [Eg Spinal Or Lateral Recess Stenosis]) During Posterior Interbody Arthrodesis Lumbar; Single Vertebral Segment (List Separately In Addition To Code For Primary Procedure)
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 56 Original policy