Artificial Intervertebral Disc | BCBS Montana | Backwork

Artificial Intervertebral Disc

BCBS Montana · PayerPolicy · BCBSMT-SUR712.028

Status: Active
Effective: January 1, 2026
Last checked by Backwork: October 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with BCBS Montana before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
0095T	CPT	Covered
0098T	CPT	Covered
0164T	CPT	Covered
0165T	CPT	Covered
22856	CPT	Covered
22857	CPT	Covered
22858	CPT	Covered
22860	CPT	Covered
22861	CPT	Covered
22862	CPT	Covered
22864	CPT	Covered
22865	CPT	Covered