64634 prior authorization | Anthem Blue Cross and Blue Shield Nevada
64634, Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve(S), With Imaging Guidance (Fluoroscopy Or Ct); Cervical Or Thoracic, Each Additional Facet Joint (List Separat, is on the Anthem Blue Cross and Blue Shield Nevada prior authorization list. Not a coverage or referral decision.
- Code
- 64634
- Description
- Destruction By Neurolytic Agent, Paravertebral Facet Joint Nerve(S), With Imaging Guidance (Fluoroscopy Or Ct); Cervical Or Thoracic, Each Additional Facet Joint (List Separat
- Source
- Nevada Prior Authorization List, Pg 72 Original policy
Anthem Blue Cross and Blue Shield Nevada prior authorization