64490 prior authorization | Anthem Blue Cross Blue Shield of California

64490, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level, is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 64490
Description: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level
Source: California PPO Prior Authorization List, Pg 110 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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