64635 prior authorization | Anthem Blue Cross and Blue Shield New Hampshire

64635, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint, is on the Anthem Blue Cross and Blue Shield New Hampshire prior authorization list. Not a coverage or referral decision.

Code: 64635
Description: Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint
Source: New Hampshire Precertification List, Pg 138 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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