Premera Blue Cross of Washington prior authorization 22858
Premera Blue Cross of Washington prior authorization for 22858: Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure) These criteria do not imply or guarantee approval.
- Code
- 22858
- Description
- Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition to code for primary procedure) These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 260 Original policy