Prior Auth Required

64640 - Destruction, Neurolytic; Other Peripheral Nerve/Branch

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / ServiceDestruction, Neurolytic; Other Peripheral Nerve/Branch
Procedure / Service Description

(fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to - (fluoroscopy or CT); lumbar or sacral, each additional facet joint (List separately in addition to 64636 code for primary procedure) 64640 Destruction, Neurolytic; Other Peripheral Nerve/Branch 64642 Chemodenervation of one extremity; 1-4 muscle(s) 64644 Chemodenervation of one extremity; 5 or more muscle(s)

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.