64484 prior authorization | Anthem Blue Cross and Blue Shield Virginia

64484, Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately, is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 64484
Description: Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or CT), lumbar or sacral, each additional level (List separately
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 25 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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