64561 prior authorization | Blue Cross and Blue Shield of Montana

64561, Percutaneous Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforaminal Placement) Including Image Guidance If Performed, is on the Blue Cross and Blue Shield of Montana commercial prior authorization list. Not a coverage or referral decision.

Code: 64561
Description: Percutaneous Implantation Of Neurostimulator Electrode Array; Sacral Nerve (Transforaminal Placement) Including Image Guidance If Performed
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 67 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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