CPT 0627T · ViaDisc · BCBS Federal Employee Program
ViaDisc / Disc Allograft — Lumbar (1st level) at BCBS Federal Employee Program.
How BCBS Federal Employee Program approaches CPT 0627T (ViaDisc / Disc Allograft — Lumbar (1st level)) for prior-authorization review: at last review on 2026-04-27, the policy does not cover this code with prior authorization required.
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FEP 7.01.166Criteria summary
High-level themes from the BCBS Federal Employee Program policy of record for CPT 0627T. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: FEP 7.01.166 — Allograft Injection for Degenerative Disc Disease
See the full BCBS Federal Employee Program criteria.
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