64636 prior authorization | Anthem Blue Cross Blue Shield of Georgia

64636, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional facet joint, is on the Anthem Blue Cross Blue Shield of Georgia 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
Source: Standard Local Prior Authorization Code List, Pg 29 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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