61891 prior authorization | Premera Blue Cross of Washington

61891, Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s), is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 61891
Description: Revision or replacement of skull-mounted cranial neurostimulator pulse generator or receiver with connection to depth and/or cortical strip electrode array(s)
Source: Clinical Review by Code List PBCWA, Pg 365 Original policy

Premera Blue Cross of Washington prior authorization

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