22858 prior authorization | Blue Cross Blue Shield Oklahoma
22858, Total Disc Arthroplasty (Artificial Disc) Anterior Approach Including Discectomy With End Plate Preparation (Includes Osteophytectomy For Nerve Root Or Spinal Cord Decompression And Microdissection); Second Level Cervical (List Separately In Addition To Code For Primary Procedure), is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.
- Code
- 22858
- Description
- Total Disc Arthroplasty (Artificial Disc) Anterior Approach Including Discectomy With End Plate Preparation (Includes Osteophytectomy For Nerve Root Or Spinal Cord Decompression And Microdissection); Second Level Cervical (List Separately In Addition To Code For Primary Procedure)
- Source
- 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 170 Original policy