13 commercial payer policies list 22869. 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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13 policies from 11 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 22869 |
|---|---|---|
| Cigna Commercial Spine Surgery Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Intraoperative Monitoring | Sep 15, 2025 | Covered with conditions |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Back Pain - Invasive Procedures | Mar 13, 2024 | Covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Disc Decompression Procedures | Not recorded | Covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| EOCCO Spine Surgery Code List | May 1, 2026 | Prior auth required |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Health Partners Plans Spine Surgery Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Interspinous Process Decompression Spacers | Nov 3, 2025 | Not covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| The Health Plan Spine Surgery Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Interspinous Fusion and Decompression Devices | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 22869 |
|---|---|---|
| Spine Procedures | Not recorded | Covered |