0216T prior authorization | Blue Cross and Blue Shield of Montana

0216T, Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Ultrasound Guidance Lumbar Or Sacral; Single Level, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 0216T
Description: Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Ultrasound Guidance Lumbar Or Sacral; Single Level
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 187 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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