Anthem Blue Cross and Blue Shield Virginia prior authorization 22869

Anthem Blue Cross and Blue Shield Virginia prior authorization for 22869: Insertion of interlaminar/interspinous process stabilization/ distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single

Code: 22869
Description: Insertion of interlaminar/interspinous process stabilization/ distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 14 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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