64561 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire
64561, Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.
- Code
- 64561
- Description
- Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed
- Source
- New Hampshire Precertification List, Pg 137 Original policy
Anthem Blue Cross and Blue Shield New Hampshire prior authorization