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BT2020111: IHCP updates policy regarding treatment of spinal stenosis

Indiana Medicaid (IHCP)·IN · Orthopedics, Neurosurgery·Medical Policy
Effective date
Nov 7, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

IHCP (Indiana Medicaid) is requiring prior authorization for four spinal stenosis procedures (CPT codes 22867-22870) effective November 7, 2020. The policy establishes specific medical necessity criteria including patient age 50+, 6 months of conservative treatment, and specific symptoms, while listing contraindications that make procedures not medically necessary.

Action Required

Action needed
By November 7, 2020: Billing team must update system to require prior authorization for CPT codes 22867, 22868, 22869, and 22870 for Indiana Medicaid patients. Providers must document medical necessity criteria including patient age 50+, 6 months of nonoperative treatment, specific symptoms, and absence of contraindications. Update encounter forms and EMR templates with required documentation checklist. Claims without prior authorization will be denied.

Affected Billing Codes

22867
22868
22869
22870