CPT 0628T · ViaDisc · BCBS Michigan
ViaDisc — Lumbar (additional level) at BCBS Michigan.
How BCBS Michigan approaches CPT 0628T (ViaDisc — Lumbar (additional level)) for prior-authorization review: at last review on 2026-04-26, the policy does not cover this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
BCBSM e-referralCriteria summary
High-level themes from the BCBS Michigan policy of record for CPT 0628T. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: BCBSM Commercial PA List — internal e-referral / medical policy
See the full BCBS Michigan criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →