64634 prior authorization | Anthem Blue Cross Blue Shield of Georgia
64634, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint, is on the Anthem Blue Cross Blue Shield of Georgia prior authorization list. Not a coverage or referral decision.
- Code
- 64634
- Description
- Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional facet joint
- Source
- Standard Local Prior Authorization Code List, Pg 29 Original policy
Anthem Blue Cross Blue Shield of Georgia prior authorization