Blue Cross and Blue Shield of Montana prior authorization 22514

Blue Cross and Blue Shield of Montana prior authorization for 22514: Percutaneous Vertebral Augmentation Including Cavity Creation (Fracture Reduction And Bone Biopsy Included When Performed) Using Mechanical Device (Eg Kyphoplasty) 1 Vertebral Body Unilateral Or Bilateral Cannulation Inclusive Of All Imaging Guidance; Lumbar

Code: 22514
Description: Percutaneous Vertebral Augmentation Including Cavity Creation (Fracture Reduction And Bone Biopsy Included When Performed) Using Mechanical Device (Eg Kyphoplasty) 1 Vertebral Body Unilateral Or Bilateral Cannulation Inclusive Of All Imaging Guidance; Lumbar
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 15 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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