Blue Cross and Blue Shield of Montana prior authorization 64490
Blue Cross and Blue Shield of Montana prior authorization for 64490: Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Image Guidance (Fluoroscopy Or Ct) Cervical Or Thoracic; Single Level
- Code
- 64490
- Description
- Injection(S) Diagnostic Or Therapeutic Agent Paravertebral Facet (Zygapophyseal) Joint (Or Nerves Innervating That Joint) With Image Guidance (Fluoroscopy Or Ct) Cervical Or Thoracic; Single Level
- Source
- 2026 Commercial Medical Surgical Prior Authorization Code List, Pg 66 Original policy