22510 prior authorization | Premera Blue Cross of Washington

22510, Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 22510
Description: Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 253 Original policy

Premera Blue Cross of Washington prior authorization

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