Blue Cross and Blue Shield of Montana prior authorization 22633

Blue Cross and Blue Shield of Montana prior authorization for 22633: Arthrodesis Combined Posterior Or Posterolateral Technique With Posterior Interbody Technique Including Laminectomy And/Or Discectomy Sufficient To Prepare Interspace (Other Than For Decompression) Single Interspace Lumbar

Code: 22633
Description: Arthrodesis Combined Posterior Or Posterolateral Technique With Posterior Interbody Technique Including Laminectomy And/Or Discectomy Sufficient To Prepare Interspace (Other Than For Decompression) Single Interspace Lumbar
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 20 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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