CPT 22513 · Vertebral Augmentation · BCBS Federal Employee Program
Kyphoplasty — Thoracic (1st level) at BCBS Federal Employee Program.
How BCBS Federal Employee Program approaches CPT 22513 (Kyphoplasty — Thoracic (1st level)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code without prior authorization.
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FEP 6.01.25Criteria summary
High-level themes from the BCBS Federal Employee Program policy of record for CPT 22513. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 4 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: FEP 6.01.25 — Percutaneous Vertebroplasty, Kyphoplasty, and Sacroplasty
See the full BCBS Federal Employee Program criteria.
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