64605 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

64605, Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 64605
Description: Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale
Source: New Hampshire Precertification List, Pg 137 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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