CPT 22842 · Other Procedure · BCBS Michigan
Posterior Segmental Instrumentation — 3-6 Segments at BCBS Michigan.
How BCBS Michigan approaches CPT 22842 (Posterior Segmental Instrumentation — 3-6 Segments) for prior-authorization review: at last review on 2026-03-15, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-03-15
Criteria summary
High-level themes from the BCBS Michigan policy of record for CPT 22842. 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: BCBSM Medical Policy — Spinal Fusion / Decompression
See the full BCBS Michigan criteria.
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