CPT 22612 · Spine Surgery · Illinois Medicaid (HFS)
Arthrodesis, Posterior — Lumbar (PLF) at Illinois Medicaid (HFS).
How Illinois Medicaid (HFS) approaches CPT 22612 (Arthrodesis, Posterior — Lumbar (PLF)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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ILMed-Surg-2026Criteria summary
High-level themes from the Illinois Medicaid (HFS) policy of record for CPT 22612. 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: IL Healthcare and Family Services — Medicaid Handbook
See the full Illinois Medicaid (HFS) criteria.
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