64636 prior authorization | Anthem Blue Cross Blue Shield of California
64636, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.
- Code
- 64636
- Description
- Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure)
- Source
- California PPO Prior Authorization List, Pg 110 Original policy
Anthem Blue Cross Blue Shield of California prior authorization