Prior Auth Required

64625 - fluoroscopy or computed tomography)

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Servicefluoroscopy or computed tomography)
Procedure / Service Description

Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when - 64624 performed Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, 64625 fluoroscopy or computed tomography) Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 64628 vertebral bodies, lumbar or sacral

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.