Prior Auth Required

64600 - Destruction by neurolytic agent, trigeminal Prior Authorization Required Investigative Submit history and physical

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceDestruction by neurolytic agent, trigeminal Prior Authorization Required Investigative Submit history and physical
Procedure / Service Description

imaging guidance, when performed; each - additional electrode array 64600 Destruction by neurolytic agent, trigeminal Prior Authorization Required Investigative Submit history and physical, nerve; supraorbital, infraorbital, mental, or documentation of medical necessity and inferior alveolar branch procedure report.

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.