61864 prior authorization | Premera Blue Cross of Washington

61864, Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site without use of intraoperative microelectrode recording; each additional array, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 61864
Description: Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site without use of intraoperative microelectrode recording; each additional array
Source: Clinical Review by Code List PBCWA, Pg 364 Original policy

Premera Blue Cross of Washington prior authorization

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