CPT 22867 · Interspinous Spacer · Florida Blue
Vertiflex — Interspinous Process Decompression (1st level) at Florida Blue.
How Florida Blue approaches CPT 22867 (Vertiflex — Interspinous Process Decompression (1st level)) for prior-authorization review: at last review on 2025-01-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-01-01
Policy number
FL-Blue-Interspinous-Spacer-MCGCriteria summary
High-level themes from the Florida Blue 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.
See the full Florida Blue criteria.
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