62264 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

62264, Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 62264
Description: Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day
Source: New Hampshire Precertification List, Pg 127 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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