64616 prior authorization | Anthem Blue Cross and Blue Shield Virginia
64616, Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.
- Code
- 64616
- Description
- Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)
- Source
- Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 26 Original policy
Anthem Blue Cross and Blue Shield Virginia prior authorization