Prior Auth Required

64636 - Destruction by neurolytic agent, Prior Authorization Required Medical Necessity History and Physical, operative report

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceDestruction by neurolytic agent, Prior Authorization Required Medical Necessity History and Physical, operative report
Procedure / Service Description

imaging guidance (fluoroscopy or CT); - imaging guidance (fluoroscopy or CT); lumbar or sacral, single facet joint 64636 Destruction by neurolytic agent, Prior Authorization Required Medical Necessity History and Physical, operative report, paravertebral facet joint nerve(s), with documentation of conservative measures imaging guidance (fluoroscopy or CT);

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.