CPT 22867 · Interspinous Device · BCBS Federal Employee Program
Vertiflex — Interspinous Process Decompression (1st level) at BCBS Federal Employee Program.
How BCBS Federal Employee Program approaches CPT 22867 (Vertiflex — Interspinous Process Decompression (1st level)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
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FEP 7.01.107Criteria summary
High-level themes from the BCBS Federal Employee Program policy of record for CPT 22867. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 26 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: FEP 7.01.107 — Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)
See the full BCBS Federal Employee Program criteria.
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