0216T prior authorization | Anthem Blue Cross Blue Shield of Georgia

0216T, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level(cid:9), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.

Code: 0216T
Description: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level(cid:9)
Source: Standard Local Prior Authorization Code List, Pg 69 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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