Spine Procedure Codes

TurningPoint Healthcare Solutions, LLC (TurningPoint) will perform Prior Authorization or Medical Necessity Determination review of the spine services represented by the CPT® and HCPCS codes listed here as part of our Surgical and Implantable Device Management Program.

Please note that the spine procedure codes listed below apply to the Surgical and Implantable Device Management Programs offered for both Horizon BCBSNJ and Horizon NJ Health patients.

This content was last revised on April 29, 2022 and may be subject to change.

Adjunct Spine- Instrumentation, Grafts, Etc.

Cervical Disc Replacement

Cervical Laminectomy and Discectomy

Cervical Spinal Fusion

Implantable Infusion Pump

Lumbar Disc Replacement

Lumbar Laminectomy, Discectomy, and Laminotomy

Lumbar Spinal Fusion

Sacral Decompression

Sacroiliac Joint Fusion

Spinal Cord Stimulator

Spinal Devices

Spinal Osteotomy

Surgery for Spinal Deformity

Thoracic Laminectomy and Discectomy

Thoracic Spinal Fusion

Vertebral Augmentation (Kyphoplasty and Vertebroplasty

Vertebral Corpectomy

TurningPoint Healthcare Solutions, LLC supports Horizon Blue Cross Blue Shield of New Jersey and Horizon NJ Health in the administration and utilization management review of certain surgical services that require the use of an implantable device for coverage. TurningPoint Healthcare Solutions, LLC independent from, and not affiliated with Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross Blue Shield Association.

CPT® is a registered trademark of the American Medical Association.