Anthem Blue Cross and Blue Shield New Hampshire prior authorization 64625

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 64625: Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)

Code: 64625
Description: Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)
Source: New Hampshire Precertification List, Pg 138 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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