64575 prior authorization | Anthem Blue Cross and Blue Shield Virginia

64575, Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 64575
Description: Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)
Source: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 26 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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