64596 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

64596, Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 64596
Description: Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array
Source: New Hampshire Precertification List, Pg 137 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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