22 commercial payer policies list 22853. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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22 policies from 14 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 22853 |
|---|---|---|
| Level of Care for Surgical Procedures | Nov 15, 2025 | Covered |
| Spine Surgery | Sep 19, 2026 | Covered |
| Spine Surgery [for Wellpoint Massachusetts] | Nov 15, 2025 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Back Pain - Invasive Procedures | Mar 13, 2024 |
| Covered |
| Idiopathic Scoliosis | Feb 15, 2024 | Covered |
|---|
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fixation (Fusion) Devices | Nov 15, 2025 | Covered |
| Lumbar Spinal Fusion | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fixation (Fusion) Devices | Nov 15, 2025 | Covered |
| Lumbar Spinal Fusion | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fixation (Fusion) Devices | Nov 15, 2025 | Covered |
| Lumbar Spinal Fusion | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fixation (Fusion) Devices | Nov 15, 2025 | Covered |
| Lumbar Spinal Fusion | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Cigna Commercial Spine Surgery Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 22853 |
|---|---|---|
| EOCCO Spine Surgery Code List | May 1, 2026 | Prior auth required |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Health Partners Plans Spine Surgery Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Cervical Spinal Fusion | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| The Health Plan Spine Surgery Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22853 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |