64625 prior authorization | Anthem Blue Cross Blue Shield of California

64625, Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (i.e., fluoroscopy or computed tomography), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.

Code: 64625
Description: Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (i.e., fluoroscopy or computed tomography)
Source: California PPO Prior Authorization List, Pg 110 Original policy

Anthem Blue Cross Blue Shield of California prior authorization

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