Anthem Blue Cross and Blue Shield Virginia prior authorization 64625

Anthem Blue Cross and Blue Shield Virginia 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: Virginia HMO/EPO standard precertification/prior authorization requirements, Pg 26 Original policy

Anthem Blue Cross and Blue Shield Virginia prior authorization

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