0164T prior authorization | Blue Cross and Blue Shield of Montana
0164T, Removal Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach Each Additional Interspace Lumbar (List Separately In Addition To Code For Primary Procedure), is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.
- Code
- 0164T
- Description
- Removal Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach Each Additional Interspace Lumbar (List Separately In Addition To Code For Primary Procedure)
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 182 Original policy