64590 prior authorization | Blue Cross Blue Shield Oklahoma

64590, Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver, is on the Blue Cross Blue Shield Oklahoma commercial prior authorization list. Not a coverage or referral decision.

Code: 64590
Description: Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 240 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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