Prior Auth Required

64612 - Chemodenervation of muscle(s); muscle(s) Prior Authorization Required Medical Necessity Submit history and physical

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceChemodenervation of muscle(s); muscle(s) Prior Authorization Required Medical Necessity Submit history and physical
Procedure / Service Description

submandibular salivary glands, bilateral documentation of medical necessity. - 64611 Chemodenervation of parotid and Prior Authorization Required Medical Necessity Submit history and physical, submandibular salivary glands, bilateral documentation of medical necessity. 64612 Chemodenervation of muscle(s); muscle(s) Prior Authorization Required Medical Necessity Submit history and physical, innervated by facial nerve, unilateral (eg, documentation of medical necessity. for blepharospasm, hemifacial spasm)

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.