CPT 22515 · Vertebral Augmentation · BCBS Texas
Kyphoplasty — Each Additional Level at BCBS Texas.
How BCBS Texas approaches CPT 22515 (Kyphoplasty — Each Additional Level) for prior-authorization review: at last review on 2024-10-28, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
MSK03-1125.1-UC0126Criteria summary
High-level themes from the BCBS Texas policy of record for CPT 22515. 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 Texas 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 →