Blue Cross and Blue Shield of Texas policy
Sphenopalatine Ganglion Block for Headache
Sphenopalatine Ganglion Block for Headache is a public Blue Cross and Blue Shield of Texas policy (policy MED205.039, effective Aug 15, 2025). It lists 7 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Policy number
- MED205.039
- Effective
- Aug 15, 2025
- Line of business
- Commercial, Medicaid
- Source
- medicalpolicy.hcsc.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Blue Cross and Blue Shield of Texas policies |
|---|---|
| 64400 | Policies naming 64400 |
| 64505 | Policies naming 64505 |
| 64999 | Policies naming 64999 |
| J1094 | Policies naming J1094 |
| J1100 | Policies naming J1100 |
| J2795 | Policies naming J2795 |
| S0020 | Policies naming S0020 |
All Blue Cross and Blue Shield of Texas policies · Blue Cross and Blue Shield of Texas prior authorization CPT list