CPT 22633 · Other Procedure · Horizon BCBS NJ
Arthrodesis, Combined Posterior + Posterior Interbody — Lumbar at Horizon BCBS NJ.
How Horizon BCBS NJ approaches CPT 22633 (Arthrodesis, Combined Posterior + Posterior Interbody — Lumbar) for prior-authorization review: at last review on 2026-03-15, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-03-15
Criteria summary
High-level themes from the Horizon BCBS NJ policy of record for CPT 22633. 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 Horizon BCBS NJ 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 →