Premera Blue Cross of Washington prior authorization 22512

Premera Blue Cross of Washington prior authorization for 22512: Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure

Code: 22512
Description: Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure
Source: Clinical Review by Code List PBCWA, Pg 254 Original policy

Premera Blue Cross of Washington prior authorization

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