64625 prior authorization | Anthem Blue Cross Blue Shield of Georgia
64625, Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography), is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- 64625
- Description
- Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
- Source
- Standard Local Prior Authorization Code List, Pg 29 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization