64625 prior authorization | Anthem Blue Cross and Blue Shield Virginia

64625, Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography), is on the Anthem Blue Cross and Blue Shield Virginia HMO/EPO prior authorization list. Not a coverage or referral decision.

Code: 64625
Description: Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
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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