Premera Blue Cross of Washington prior authorization 64584

Premera Blue Cross of Washington prior authorization for 64584: Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array These criteria do not imply or guarantee approval.

Code: 64584
Description: Removal of hypoglossal nerve neurostimulator array, pulse generator, and distal respiratory sensor electrode or electrode array These criteria do not imply or guarantee approval.
Source: Clinical Review by Code List PBCWA, Pg 378 Original policy

Premera Blue Cross of Washington prior authorization

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