Premera Blue Cross of Washington prior authorization 22632

Premera Blue Cross of Washington prior authorization for 22632: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace These criteria do not imply or guarantee approval.

Code: 22632
Description: Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 258 Original policy

Premera Blue Cross of Washington prior authorization

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