22585 CPT® code: payer coverage and prior authorization60 of 61 payer prior-auth lists that name 22585 require prior authorization or set conditions: Aetna, Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, CarePlus Health Plans, Cigna, Humana, Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Texas, Molina Healthcare of Utah, and others.
22585 appears in 28 coverage policies from Aetna, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 22548-22812) | Oct 6, 2026 | payer document |
| Aetna | Bone and Tendon Graft Substitutes and Adjuncts (0411) | listed, no stance (range 22548-22819) | Aug 18, 2026 | payer document |
| Aetna | Bone and Tendon Graft Substitutes and Adjuncts (0411) | listed, no stance (range 22548-22586) | Aug 18, 2026 | payer document |
| Aetna | Idiopathic Scoliosis (0398) | covered if criteria are met (range 22548-22819) | Sep 28, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | covered if criteria are met | Jun 19, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | covered if criteria are met (range 22532-22819) | Jun 19, 2026 | payer document |
| Aetna | Intraoperative Neurophysiological Monitoring (0697) | not covered (range 22010-22899) | Jun 19, 2026 | payer document |
| Aetna | Negative Pressure Wound Therapy (0334) | listed, no stance (range 22532-22819) | Jun 8, 2026 | payer document |
| Aetna | Nerve Blocks (0863) | listed, no stance (range 22010-22899) | Jul 23, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range 22548-22812) | Jan 20, 2026 | payer document |
| Aetna | Remote Ischemic Conditioning (0814) | listed, no stance (range 20000-29999) | Nov 20, 2025 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 20100-29999) | Jul 29, 2026 | payer document |
| Aetna | Spinal Surgery: Laminectomy and Fusion (0743) | covered if criteria are met | Jul 30, 2026 | payer document |
| Aetna | Spinal Surgery: Laminectomy and Fusion (0743) | listed, no stance | Jul 30, 2026 | payer document |
| Blue Cross NC | Orthopedic Applications of Stem Cell Therapy | listed, no stance | Feb 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Lumbar Spinal Fusion (SUR712.036) CPT Codes 20930, 20931, 20936, 20937, 20938, 20939, 22533, 22534, 22558, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Cervical Spine Surgeries: Discectomy, Laminectomy, and Fusion in Adults (7.01.560) | listed, no stance | Aug 24, 2026 | payer document |
| Premera Blue Cross | Lumbar Spinal Fusion in Adults (7.01.542) | listed, no stance | Jun 1, 2026 | payer document |
| Regence | Cervical Spinal Fusion (Surgery 244) | listed, no stance | Mar 1, 2026 | payer document |
| Regence | Lumbar Spinal Fusion (Surgery 187) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (CS365.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (2026T0639J) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Idaho Only) (CS365ID.D) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Kansas Only) (CS365KS.02) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Kentucky Only) (CS365KY.05) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for New Jersey Only) (CS365NJ.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for New Mexico Only) (CS365NM.C) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for North Carolina Only) (CSNCT0365.05) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Ohio Only) (CS365OH.D) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Pennsylvania Only) (CS365PA.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Spinal Fusion and Decompression (for Tennessee Only) (CS365TN.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | This Medical Policy only applies to the State of Nebraska. (CS365NE.E) | listed, no stance | May 1, 2026 | payer document |
Prior authorization required or conditional in CO, WA, WY.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.