64596 prior authorization | Anthem Blue Cross Blue Shield of Georgia
64596, Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- 64596
- Description
- Insertion or replacement of percutaneous electrode array, peripheral nerve, with integrated neurostimulator, including imaging guidance, when performed; initial electrode array
- Source
- Standard Local Prior Authorization Code List, Pg 133 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization