CPT 22867 · Interspinous Device · Highmark BCBS
Vertiflex — Interspinous Process Decompression (1st level) at Highmark BCBS.
How Highmark BCBS approaches CPT 22867 (Vertiflex — Interspinous Process Decompression (1st level)) for prior-authorization review: at last review on 2026-04-26, the policy covers this code with prior authorization required.
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eviCore MSK Spine Surgery (Highmark)Criteria summary
High-level themes from the Highmark BCBS 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: eviCore MSK Spine Surgery — Interspinous Distraction Device (Highmark commercial PA)
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