CPT 22612 · Spine Surgery · New York No-Fault PIP
Arthrodesis, Posterior — Lumbar (PLF) at New York No-Fault PIP.
How New York No-Fault PIP 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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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-02
Policy number
NY-No-Fault-2026Criteria summary
High-level themes from the New York No-Fault PIP 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.
See the full New York No-Fault PIP criteria.
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