64584 prior authorization | Premera Blue Cross of Washington

64584, Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array These criteria do not imply or guarantee approval., is on the Premera Blue Cross of Washington prior authorization list. Not a coverage or referral decision.

Code: 64584
Description: Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 378 Original policy

Premera Blue Cross of Washington prior authorization

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