63685 prior authorization | Premera Blue Cross of Washington

63685, Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator receiver, is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 63685
Description: Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator receiver
Source: Clinical Review by Code List PBCWA, Pg 377 Original policy

Premera Blue Cross of Washington prior authorization

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