Prior Auth Required

64624 - Investigational Destruction by neurolytic agent, genicular nerve branches including

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceInvestigational Destruction by neurolytic agent, genicular nerve branches including
Procedure / Service Description

Mountain Health Co-Op, Services Requiring Prior Authorization 54 - Neurostimulator 64595 REVISE/REMOVE PERIPH/GASTRIC NEUROSTIM/RECEIVER Investigational 64624 Destruction by neurolytic agent, genicular nerve branches including Potential imaging guidance, when

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