CPT 22514 · Vertebral Augmentation · Ambetter
Kyphoplasty — Lumbar (1st level) at Ambetter.
How Ambetter approaches CPT 22514 (Kyphoplasty — Lumbar (1st level)) for prior-authorization review: at last review on 2024-01-01, the policy covers this code with prior authorization required.
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Centene CP equivalentVerification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Ambetter policy of record for CPT 22514. 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: Ambetter / Centene
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