CPT 22868 · Interspinous Spacer · Excellus BCBS
Vertiflex — Interspinous (add'l level) at Excellus BCBS.
How Excellus BCBS approaches CPT 22868 (Vertiflex — Interspinous (add'l level)) for prior-authorization review: at last review on 2026-04-27, the policy does not cover this code with prior authorization required.
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Coverage
Not covered
Prior auth
Prior auth required
InvestigationalInvestigational / experimental
Last reviewed
2026-04-27
Policy number
7.01.113Criteria summary
High-level themes from the Excellus BCBS policy of record for CPT 22868. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Excellus BCBS Medical Policy 7.01.113 — Lumbar Decompression
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