22533 prior authorization | Premera Blue Cross of Washington

22533, Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar 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: 22533
Description: Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 255 Original policy

Premera Blue Cross of Washington prior authorization

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