CPT 63047 · Spine Surgery · California Medicaid (Medi-Cal)
Laminectomy + Facetectomy + Foraminotomy — Lumbar at California Medicaid (Medi-Cal).
How California Medicaid (Medi-Cal) approaches CPT 63047 (Laminectomy + Facetectomy + Foraminotomy — Lumbar) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2026-05-02
Policy number
Medi-Cal-Surg-2026Criteria summary
High-level themes from the California Medicaid (Medi-Cal) policy of record for CPT 63047. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
See the full California Medicaid (Medi-Cal) criteria.
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