CPT 22869 · Interspinous Device · Aetna Medicare Advantage
Vertiflex — Interspinous (1st level, no decompression) at Aetna Medicare Advantage.
How Aetna Medicare Advantage approaches CPT 22869 (Vertiflex — Interspinous (1st level, no decompression)) for prior-authorization review: at last review on 2026-05-08, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-08
Policy number
Clearway-MPG-MinuteMan_InspanCriteria summary
High-level themes from the Aetna Medicare Advantage policy of record for CPT 22869. 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 Aetna Medicare Advantage criteria.
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