CPT 22514 · Vertebral Augmentation · BCBS Montana
Kyphoplasty — Lumbar (1st level) at BCBS Montana.
How BCBS Montana approaches CPT 22514 (Kyphoplasty — Lumbar (1st level)) for prior-authorization review: at last review on 2024-10-28, the policy covers this code with prior authorization required.
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MSK03-1125.1-UC0126Criteria summary
High-level themes from the BCBS Montana policy of record for CPT 22514. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Carelon Clinical Appropriateness Guidelines — Spine Surgery (Vertebroplasty/Kyphoplasty section)
See the full BCBS Montana criteria.
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