Anthem Blue Cross Blue Shield of Georgia prior authorization 64494

Anthem Blue Cross Blue Shield of Georgia prior authorization for 64494: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level

Code: 64494
Description: Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; second level
Source: Standard Local Prior Authorization Code List, Pg 28 Original policy

Anthem Blue Cross Blue Shield of Georgia prior authorization

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