Blue Cross and Blue Shield of Montana prior authorization 61867

Blue Cross and Blue Shield of Montana prior authorization for 61867: Twist Drill Burr Hole Craniotomy Or Craniectomy With Stereotactic Implantation Of Neurostimulator Electrode Array In Subcortical Site (Eg Thalamus Globus Pallidus Subthalamic Nucleus Periventricular Periaqueductal Gray) With Use Of Intraoperative Microelectrode Recording; First Array

Code: 61867
Description: Twist Drill Burr Hole Craniotomy Or Craniectomy With Stereotactic Implantation Of Neurostimulator Electrode Array In Subcortical Site (Eg Thalamus Globus Pallidus Subthalamic Nucleus Periventricular Periaqueductal Gray) With Use Of Intraoperative Microelectrode Recording; First Array
Source: 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 50 Original policy

Blue Cross and Blue Shield of Montana prior authorization

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