Prior Auth Required

64585 - Revision/removal peripheral neurostimulator electrode array All

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceRevision/removal peripheral neurostimulator electrode array All
Procedure / Service Description

Service Category Benefit/Description Codes Requiring Authorization Member Program* - Neurostimulator implants – cranial/peripheral/gastric (code set) 61850, 61860, 61863, 61864, 61867, 61868, 61885, 61886, 64553, 64568, 64555, 64561, 64566, 64575, 64580, 64581, 64590 All Revision/replacement cranial nerve (e.g., vagus) neurostimulator electrode array 64569 All Revision/removal peripheral neurostimulator electrode array 64585 All Revision/removal peripheral or gastric neurostimulator pulse generator/receiver 64595 All Neurostimulator additions (electrodes, generators, etc.) L8679, L8680, L8681, L8682, L8683, L8684, L8685, L8686, L8687, L8688, L8689, L8695 All

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.