Prior Auth Required

64642 - Chemodenervation of one extremity; 1-4 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 one extremity; 1-4 Prior Authorization Required Medical Necessity Submit history and physical
Procedure / Service Description

(List separately in addition to code for - peripheral nerve or branch documentation of conservative measures 64642 Chemodenervation of one extremity; 1-4 Prior Authorization Required Medical Necessity Submit history and physical, muscle(s) documentation of medical necessity. 64643 Chemodenervation of one extremity; each Prior Authorization Required Medical Necessity Submit history and physical,

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.