CPT 22558 · Spine Surgery · Medicare (FCSO MAC)
Arthrodesis, Anterior Interbody — Lumbar (ALIF/DLIF/XLIF/LLIF/OLIF) at Medicare (FCSO MAC).
How Medicare (FCSO MAC) approaches CPT 22558 (Arthrodesis, Anterior Interbody — Lumbar (ALIF/DLIF/XLIF/LLIF/OLIF)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code without prior authorization.
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No active LCD (First Coast)Criteria summary
High-level themes from the Medicare (FCSO MAC) policy of record for CPT 22558. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: CMS IOM 100-08 — Reasonable and Necessary Coverage; First Coast MAC
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